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Propranolol for Treatment of Infantile Hemangioma: Efficacy and Effect on Pediatric Growth and Development

Rachel A Giese1, Merit Turner2, Mario Cleves3

  • 1Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Texas Rio Grande Valley School of Medicine, 1201 W University Dr, Edinburg, TX, Canada 78539.

International Journal of Pediatrics
|April 30, 2021
PubMed

Insights

Propranolol effectively treats infantile hemangiomas (IH) without negatively impacting growth or development. This study found no significant adverse effects on physical growth, developmental milestones, or human growth hormone (hGH) levels in infants receiving propranolol.

Area of Science:

  • Pediatric Endocrinology
  • Dermatology
  • Pharmacology

Background:

  • Infantile hemangiomas (IH) are common vascular tumors in infants.
  • Propranolol is a first-line treatment for problematic IH.
  • Concerns exist regarding propranolol's potential effects on growth and development.

Purpose of the Study:

  • To evaluate the impact of propranolol on physical growth in infants with IH.
  • To assess developmental milestones in infants treated with propranolol.
  • To measure human growth hormone (hGH) levels in infants receiving propranolol therapy.

Main Methods:

  • Prospective collection of monthly height and weight data for 185 infants with IH.
  • Comparison of growth data to World Health Organization (WHO) z-scores.
  • Assessment of developmental milestones and guardian satisfaction via questionnaires and chart reviews.
  • Measurement of hGH levels in a cohort of treated and untreated infants.

Main Results:

  • No deviation from normal weight was observed in either cohort (with or without comorbidities).
  • A significant deviation in BMI-for-age and weight-for-age z-scores was noted, particularly for those on propranolol >7 months.
  • Most infants met developmental milestones on time, irrespective of comorbidities.
  • Eighty percent of guardians observed clinical improvement in IH; 91% were satisfied with treatment.
  • hGH levels were higher in the propranolol group but not significantly different.

Conclusions:

  • Propranolol is an effective and well-tolerated treatment for infantile hemangiomas.
  • Propranolol therapy does not appear to impair physical growth in infants with IH.
  • Propranolol treatment does not negatively impact normal pediatric development.
Abstract

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