Propranolol vs corticosteroids for infantile hemangiomas: a multicenter retrospective analysis

Area of Science:

• Pediatric Dermatology
• Vascular Anomalies
• Pharmacology

Background:

• Infantile hemangiomas (IHs) are common benign vascular tumors in infants.
• Treatment options for IHs have evolved, with a need for safe and effective therapies.
• Oral corticosteroids have been a traditional treatment but are associated with significant side effects.

Purpose of the Study:

• To compare the safety and efficacy of propranolol therapy versus oral corticosteroids for infantile hemangiomas.
• To evaluate treatment outcomes, including clearance rates and adverse events.
• To determine if propranolol is a superior treatment option for IHs.

Main Methods:

• Multicenter retrospective chart review of 110 patients with IHs.
• Quantification of lesion clearance using serial photography and clinical measurements (≥75% vs. <75% clearance).
• Comparison of treatment duration, adverse effects, relapse rates, and need for surgical intervention between propranolol and corticosteroid groups.

Main Results:

• Propranolol therapy (82% clearance) was significantly more effective than oral corticosteroids (29% clearance) (P < .01).
• Adverse effects were minimal with propranolol (3%), compared to all patients on corticosteroids (P < .01).
• Fewer surgical referrals were needed after propranolol treatment (12%) versus corticosteroids (29%) (P < .01).

Conclusions:

• Propranolol therapy is clinically effective, safe, and well-tolerated for infantile hemangiomas.
• Propranolol demonstrates superior efficacy and fewer adverse effects compared to oral corticosteroids.
• Propranolol should be considered a first-line treatment for IHs due to its favorable safety and efficacy profile.