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Efficacy and safety of propranolol as first-line treatment for infantile hemangiomas

Clemens Schiestl1, Kathrin Neuhaus, Silke Zoller

  • 1Division of Plastic Surgery, University Children's Hospital Zurich, Zurich, Switzerland.

European Journal of Pediatrics
|October 12, 2010
PubMed

Insights

Propranolol is an effective first-line treatment for complicated infantile hemangiomas (IH), showing significant reduction in size and color. This beta-blocker demonstrates good tolerance and minimal hemodynamic impact in infants.

Area of Science:

  • Pediatric Dermatology
  • Vascular Anomalies
  • Pharmacology

Background:

  • Complicated infantile hemangiomas (IH) are a significant concern.
  • Beta-blockers show promise for IH treatment, but data on propranolol as a first-line therapy is limited.
  • Objective outcome measures and hemodynamic effects in infants require further investigation.

Purpose of the Study:

  • To evaluate propranolol as a first-line treatment for proliferating complicated infantile hemangiomas.
  • To assess objective outcomes using visual analogue scale (VAS), ultrasound, and ophthalmological review.
  • To monitor tolerance and hemodynamic changes in infants receiving propranolol.

Main Methods:

  • Retrospective evaluation of 25 infants with complicated IH treated with propranolol (2 mg/kg/day).
  • Outcome assessment via blinded photographic evaluation (VAS), ultrasound, and ophthalmological review.
  • In-patient monitoring for tolerance and hemodynamics during initial therapy.

Main Results:

  • Significant reduction in IH color (VAS -9) and size (VAS -8) after 7 months.
  • Ultrasound showed a decrease in lesion thickness from 14 mm to 10 mm (p < 0.01).
  • Periocular IH cases resolved rapidly; overall tolerance was good with no significant hemodynamic changes.

Conclusions:

  • Propranolol is highly effective for complicated infantile hemangiomas.
  • The therapy is well-tolerated with a favorable safety profile in infants.
  • Propranolol is proposed as a first-line treatment for infantile hemangiomas.
Abstract

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