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Oral propranolol therapy in 23 infants with infantile hemangioma

Jaeyoon Kim¹, Jong Won Hong¹, Tai Suk Roh¹

¹Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.

Archives of Plastic Surgery

|November 24, 2018

Insights

Propranolol effectively treats infantile hemangioma (IH). Treatment outcomes for IH depend on lesion number, patient sex, and age at treatment initiation, with single lesions, male patients, and early treatment showing better results.

Area of Science:

Pediatric Dermatology
Vascular Biology
Pharmacology

Background:

Infantile hemangioma (IH) is a prevalent pediatric vascular tumor.
Propranolol is a common treatment for IH.
This study evaluates propranolol's efficacy and safety in 23 IH patients.

Purpose of the Study:

To assess propranolol dosage, treatment response, and side effects in pediatric patients with infantile hemangioma.
To identify factors influencing treatment outcomes in IH.

Main Methods:

A nonrandomized comparative cohort study involving 23 IH patients treated with propranolol.
Objective analysis of treatment response using computer-assisted photographic evaluation at multiple time points.
Comparison of outcomes based on lesion characteristics, patient demographics, and treatment timing.

Main Results:

Patients with a single lesion showed significantly better color fading and size reduction compared to those with multiple lesions (P<0.001).
Male patients exhibited greater color change (a-value) than female patients (P<0.001).
Early treatment initiation (before 6 months) resulted in greater size reduction (62.3%) versus later treatment (15.8%) (P<0.001).

Conclusions:

Propranolol is an effective and safe treatment for infantile hemangioma.
Treatment response is superior for single lesions, male patients, and when initiated before six months of age.
These findings aid in optimizing propranolol therapy for IH based on patient-specific factors.

Read full analysis

Abstract

Background:

Infantile hemangioma (IH) is a common vascular tumor in pediatric patients, and is commonly treated with propranolol. We describe our experiences with dosage, response to treatment, and side effects in 23 IH patients treated with propranolol.

Methods:

For this nonrandomized comparative cohort study, the authors enrolled 23 patients treated with propranolol. Photographs were taken before propranolol administration and at 3, 6, 9, and 12 months after treatment. Treatment responses were objectively analyzed with a computer program.

Results:

There were three male and 20 female patients. Common tumor locations were the head and neck (13 cases, 56.5%), trunk (four cases, 17.4%), extremities (three cases, 13.0%), and combined locations (three cases, 13.0%). The response to propranolol was significantly lower in patients with two or more lesions than in patients with a single lesion in terms of both color fading (P<0.001) and size reduction (P<0.001). In male patients (42.2±3.9), the change in a-values, indicating coloration, was higher than in female patients (19.8 ±13.8) (P<0.001). In patients who started treatment before 6 months after birth, the size reduction was greater than in their counterparts (62.3%; range, 3.0%-93.0% vs. 15.8%; range, 1.0%-79.0%; P<0.001).

Conclusions:

Propranolol is an efficacious treatment with a good safety profile. In patients with a single lesion, the response to treatment was better in terms of color fading and size reduction. Furthermore, male patients responded better to propranolol treatment in terms of color fading than female patients, and starting treatment before 6 months after birth was more advantageous for size reduction.

Keywords:

Hemangioma Propranolol Therapeutics

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