Therapies for Infantile Haemangiomas: Current Practice and Evolving Perspectives

Area of Science:

• Vascular Biology
• Pediatric Dermatology
• Pharmacology

Background:

• Infantile haemangiomas (IH) are common benign vascular tumors in infants.
• While most IH involute spontaneously, some risk complications like ulceration or disfigurement.
• Previous treatments had limited efficacy and significant toxicity.

Purpose of the Study:

• To review the evolution of drug therapy for infantile haemangiomas.
• To integrate mechanistic insights, clinical approaches, and patient-centered innovations in IH management.
• To discuss the current trajectory of care for infantile haemangiomas.

Main Methods:

• Review of historical and current therapeutic strategies for IH.
• Analysis of mechanistic actions of propranolol and other beta-blockers.
• Integration of clinical trial data, observational studies, and recent innovations.

Main Results:

• Propranolol revolutionized IH treatment, becoming the first-line therapy due to prompt and sustained regression.
• Mechanisms include vasoconstriction, suppressed angiogenesis, endothelial apoptosis, and adipogenic differentiation.
• Alternative beta-blockers and other agents have specific roles, while older therapies are reserved for salvage.

Conclusions:

• Propranolol offers a favorable safety profile with expert supervision, though hypoglycemia requires careful management.
• Rebound growth is manageable with re-treatment; alternative beta-blockers may offer tolerability advantages.
• Digital health innovations can improve access and reduce healthcare burden for IH patients.