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Our experience with propranolol for infantile hemangioma
Yao Wu1, Piaoping Zhao1, Wei Song1
1Department of Dermatology, Children's Hospital of Fudan University and National Children Medical Center, Shanghai, China.
Insights
Early propranolol treatment for infantile hemangioma (IH) leads to faster regression. Prompt treatment initiation is recommended for better outcomes in IH management, with careful monitoring for dosage adjustments.
Area of Science:
- Pediatric Dermatology
- Vascular Biology
- Pharmacology
Background:
- Infantile hemangioma (IH) is the most common benign vascular tumor in children.
- Propranolol is the first-line treatment for severe IH.
- Optimal timing for initiating and discontinuing propranolol remains debated.
Purpose of the Study:
- To investigate the impact of early propranolol treatment on infantile hemangioma regression.
- To identify factors influencing treatment duration and recurrence rates.
- To evaluate the optimal timing for propranolol dosage reduction.
Main Methods:
- A retrospective study of 90 patients with infantile hemangioma treated with propranolol between 2016 and 2019.
- Patients were categorized into complete and partial regression groups based on treatment outcomes.
- Color Doppler ultrasound was used to assess hemangioma characteristics.
Main Results:
- The complete regression group had a significantly shorter initial treatment period (4.3 months) compared to the partial regression group (5.2 months).
- Treatment duration was longer in the partial regression group (32.9 months) versus the complete regression group (23.4 months).
- Facial hemangiomas, particularly periocular, showed a higher proportion in the regression group.
Conclusions:
- Early initiation of propranolol treatment for infantile hemangioma is associated with faster regression.
- Patient age and tumor regression percentage are key factors in determining propranolol dosage reduction.
- Periocular hemangiomas may have a better prognosis, warranting further investigation.
Background/Objectives:
The most frequent benign vascular tumor in children is infantile hemangioma (IH). For severe IHs, propranolol has become the first-line Treatment. Despite the fact that several studies have comprehensive therapy regimens, including the best time to start Treatment, dosage, visit frequency, and treatment duration, there is still controversy about the best time to start and stop propranolol medication.
Methods:
Between January 2016 and February 2019, dermatologists experienced hemangioma treatment and recommended propranolol treatment for 232 IHs. A total of 90 patients completed the treatment process after undergoing a color Doppler ultrasound test.
Results:
Propranolol uniquely affects each IH. Ninety patients were divided into two groups in this study: entire regression (n = 40) and partial regression (n = 50). The entire regression group's initial treatment period (4.3 ± 2.97 months) was substantially shorter than the partial regression group's (5.2 ± 4.57 months) (p < 0.05). Between the entire regression group (23.4 ± 12.8 months) and the partial regression group (24.5 ± 16.6 months), there was no significant difference in time to reduce propranolol. The partial regression group (32.9 ± 25.3month) had a lengthier treatment course than the entire regression group (23.4 ± 13.7 months) (p < 0.05). The partial regression group (22%), like the entire regression group, had a higher recurrence rate (5%). The overall proportion of hemangiomas on the face (particularly periocular hemangioma) in the regression group was greater than in the control group.
Conclusion:
The entire regression group's initial treatment time was significantly shorter than the partial regression group's. As a result, as soon as a hemangioma is discovered, it should be treated. To determine the appropriate time to reduce propranolol, we must evaluate the patient's age and the percentage of tumor regression. Periocular hemangioma may have a better prognosis than other types. Given the small number of patients in our study, we will need to do more research in the future to confirm our findings.
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