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Propranolol Treatment for Infantile Hemangiomas: Short-Term Adverse Effects and Follow-Up to Age Two
Xueqing Li1, Kun Yang1, Hongwen Li1
1Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, China.
Insights
Oral propranolol is generally well-tolerated for infantile hemangiomas (IHs). Younger children may experience more central nervous system (CNS) side effects, but propranolol does not impact growth in two-year-olds.
Area of Science:
- Pediatric Dermatology
- Pharmacology
- Clinical Research
Background:
- Infantile hemangiomas (IHs) are common vascular tumors in infants.
- Propranolol is a first-line treatment for IHs, but its short-term adverse effects (AEs) and impact on growth require further investigation.
Purpose of the Study:
- To analyze the short-term adverse effects (AEs) of propranolol in infantile hemangioma (IH) treatment.
- To identify factors associated with propranolol AEs.
- To evaluate the relationship between propranolol treatment and child growth.
Main Methods:
- Retrospective analysis of 439 patients with IHs treated with propranolol.
- AEs were analyzed using single-factor and binary logistic regression.
- Growth (height and body weight) in 292 two-year-olds was compared to reference ranges and correlated with treatment duration.
Main Results:
- 16.0% of patients experienced AEs, most commonly gastrointestinal (GI) or central nervous system (CNS) symptoms.
- Starting propranolol at ≤3 months of age was associated with increased CNS AEs (OR=0.303).
- Two-year-old children showed normal height and body weight, unrelated to propranolol treatment duration.
Conclusions:
- Oral propranolol demonstrates good tolerance for IH treatment.
- Younger children (<3 months) are more susceptible to CNS adverse effects.
- Propranolol treatment does not negatively impact growth in two-year-old children.
Objective:
To analyse the short-term adverse effects (AEs) of propranolol in the treatment of infantile hemangiomas (IHs) and their relevant factors, as well as the relationship between child growth and propranolol.
Methods:
A total of 506 patients with confirmed or suspected IHs were enrolled, and a total of 439 cases were included in the study. Short-term AEs were analysed using single-factor analysis and binary logistic regression. Out of 439 patients, 292 were enrolled to examine the effect of propranolol on 2-year-olds' height and body weight (BW), by comparison with reference range and among groups. Spearman rank correlation analysis was used to determine the relationship between BW, height, and duration of propranolol treatment.
Results:
Among 439 patients, 70 (16.0%) experienced AEs. Among them, 48 had gastrointestinal (GI) symptoms, 23 had central nervous system (CNS) symptoms, 8 had both symptoms above, and 7 had other symptoms. Most of the AEs occurred on the starting day (day 0), and 6 children's AEs were transient. Starting age of no older than 3 months led to more CNS symptoms, and starting age of older than 3 months was a protective factor against CNS symptoms, with an OR value of 0.303 (0.117-0.783). Height and BW of 292 two-year-old children were no less than the reference levels, although those of 3 females and 1 male were less than the average -2 standard deviation (-2SD). The height and BW of the children at the age of two was not related to the length of time of propranolol treatment.
Conclusion:
Oral propranolol has a good tolerance in the treatment of IHs. Oral propranolol exerts more adverse effects on the CNS of lower age children, and it has exhibited no effect on the growth of two-year-old children.
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