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[Infantile hemangioma: a new indication for propranolol? Retrospective study: a case-series of 25 infants]
Insights
Propranolol effectively treats complicated infantile hemangioma (IH) in infants, with all patients showing improvement and good tolerance. This study confirms propranolol as a suitable first-line therapy for IH.
Area of Science:
- Pediatric Dermatology
- Pharmacology
- Neonatal Care
Background:
- Infantile hemangioma (IH) is a common pediatric vascular tumor.
- Complicated IH requires effective treatment options.
- Propranolol emerged as a promising treatment for IH in 2008.
Purpose of the Study:
- To evaluate the safety and efficacy of propranolol for complicated infantile hemangioma.
- To identify and characterize adverse events associated with propranolol treatment in infants.
- To assess treatment response rates in children with complicated IH.
Main Methods:
- Retrospective, observational case-series study.
- Involved 25 pediatric patients with complicated infantile hemangioma.
- Data collected on adverse events, treatment duration, and response to propranolol therapy.
Main Results:
- 100% of patients showed a favorable response at the first visit.
- Complete response in 9 patients, subtotal in 9, and partial in 3 by end of treatment.
- 48% experienced transient adverse events, managed by dose adjustment; 2 patients discontinued treatment due to parental concerns.
Conclusions:
- Propranolol demonstrated high efficacy in treating complicated infantile hemangioma.
- All patients exhibited improvement, with no non-responders.
- Good global tolerance and manageable adverse events support propranolol as a first-line treatment for complicated IH.
Background:
In 2008, the New England Journal of Medicine reported a new indication for propranolol: treatment of complicated infantile hemangioma (IH). The objective of this study is to identify any adverse events and to measure the efficacy of propranolol in children with complicated IH, through a retrospective, observational, case-series study of 25 patients treated with propranolol at the Hôpital Universitaire des Enfants Reine Fabiola in Belgium.
Observations:
25 patients were submitted to this therapy. The treatment was stopped prematurely for two of them, by parental fear of side effects and 48 % presented one or more adverse events; all of which were transient and rapidly controlled by adjusting the doses administered. Mean age at the start of treatment was 4,8 months. A clearly favorable response was observed in 100 % of patients at their first visit after treatment initiation ; a total response was seen in 9 patients, with subtotal and partial responses observed in 9 and 3 patients, respectively, by the end of treatment.
Conclusion:
The real efficacy of propranolol for complicated IH was confirmed by the clearly evident improvement observed in all patients and the absence of non-responders. As global tolerance was also good, propranolol can therefore be considered to be an appropriate first- line treatment for complicated IH.
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