Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children (original) (raw)

Oral Versus Topical Propranolol in Management of Infantile Hemangioma

al-azhar medical journal, 2021

Background: Infantile hemangiomas (IHs) are the most common soft tissue tumors of infancy, which occur in 4% to 10% of children under 1 year of age. Female infants are three to four times more likely suffering from IH as male infants. Hemangioma may require no treatment except if any complications occur. Objective: To compare the efficacy of orally administered propranolol versus topical propranolol in the management of infantile hemangiomas in infants and children below 7 years of age. Patients and Methods: These studies were conducted on 40 patients attending to Egyptian Military Hospitals with Infantile hemangioma, and were divided into two groups: Group A received oral propranolol and Group B received topical propranolol for 6 months in both groups, this was from February 2019 to November 2019. Results: Oral and topical propranolol achieved a satisfactory results with no significant difference in both groups, with mean reduction in size of 36.55% and 34.54% respectively accordin...

Oral propranolol: an effective, safe treatment for infantile hemangiomas

European journal of dermatology : EJD

Infantile hemangiomas (IH) are the most common childhood tumors. In 2008, Labreze reported the serendipitous effect of oral propranolol on hemangioma and since then it has overshadowed the use of other therapeutic modalities in the treatment of IH. The aim of this prospective, clinical study was to assess the efficacy and safety profile of oral propranolol at a fixed dose of 2 mgkg(-1) in the treatment of 30 patients with problematic IH. Propranolol treatment continued for a duration of 2-14 months where 60% of the patients (n=18) showed a final excellent response with complete resolution of the lesion (P<0.001). 20% (n=6) showed a good response with more than 50% reduction in the size of the IH. 16.6% showed a fair response (n=5) with less than 50% reduction in the size of the IH. Only one patient (3.3%) was resistant to treatment. Five patients (17.24%) showed evidence of rebound growth after cessation of therapy and responded well to re-treatment.We did not face any side effec...

The use of propranolol for complicated infantile hemangiomas

International Journal of Dermatology, 2013

Objective To assess propranolol efficacy and safety in complicated infantile hemangiomas in two different age groups. Patients and methods We report on 68 infants with infantile hemangiomas treated with oral propranolol at the lowest effective dose at different ages for a period of six months. Inclusion criteria were life-threatening hemangiomas, function-threatening hemangiomas, facial hemangiomas with risk for disfigurement, and extensive and ulcerated hemangiomas. A previously designed safety protocol was applied to all patients. The evolution of all hemangiomas since baseline (pre-therapy) until the end of follow-up was assessed on the basis of clinical features (color, palpable softening, size, and volume) and taken at followup visits. Results Our results showed that propranolol was effective in arresting the proliferative phase and in accelerating the involution of infantile hemangiomas in 92.6% of cases. Propranolol efficacy was clear even when it was started after 12 months of life at low dose; after discontinuation of therapy there was a moderate-to-severe regrowth in 9.3% of cases and a mild regrowth in 22.5%. No adverse events were observed. Conclusions Propranolol should be used as first-line medical treatment in all cases of complicated infantile hemangiomas.

Propranolol for infantile hemangioma: An evaluation of its efficacy and safety in Iranian infants

Iranian Journal of Neonatology IJN, 2016

Background: Propranolol has been recently indicated to inhibit the rapid growth and involution of infantile hemangioma. In the present study, we investigated the efficacy and safety of propranolol in Iranian infants. Methods: A total of 30 infants with indications for medical intervention, such as large hemangiomas, wounds with or without secondary infection, or active trauma-induced bleeding, were selected. First, a total concentration of 1 mg/kg/day was orally administered to the infants; the dosage further increased (2-3 mg/kg/day) in case the infants experienced no adverse effects. Following weekly (one month after treatment) and monthly (up to six months) follow-ups, hemangioma activity score (HAS) was calculated to evaluate swelling, color of the lesion, and ulcer size. Results: In the present study, infants with the mean age of 5.33±3.50 years received therapy. Improvement was observed in the lesions of all patients, characterized by a significant decline in size, change in c...

Review the experience: role of propranolol in infantile hemangioma (IHs) on pediatric patient

International Surgery Journal, 2018

Infantile hemangiomas (IHs) are common benign and usually self-involution tumor (swelling or growth) of the endothelial-like cells or affect approximately 1 in 10 children. They tend to follow a natural course of rapid proliferation during the first year of life and subsequently regress over 5-10 years. 1 The period and rate of growth are variable; some infants will have hemangiomas that grow very little, whereas others grow rapidly and at an unpredictable rate. Although most are not worrisome, ∼12% of IHs are significantly complex, requiring referral to specialists for consideration of treatment. 2,3 Complications of hemangiomas, for which systemic pharmacotherapy is typically initiated, include permanent disfigurement, ulceration, bleeding, visual compromise, airway obstruction, congestive heart failure and, rarely, death. Despite the relative frequency of IHs and the ABSTRACT Background: Although not being licensed for the treatment of infantile hemangiomas (IHs) on pediatric patient 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience on pediatric patients with efficacy and adverse effects after use of oral propranolol treatment for IHs started before 5 weeks or after 5 months of age. Methods: This was an observational study performed pediatric patients with IHs treated with oral propranolol at the

Propranolol in the management of infantile hemangiomas: clinical response and predictors

Journal of cutaneous medicine and surgery

Recent data suggest that propranolol is an effective treatment for infantile hemangiomas (IHs). Data on the optimal dose, duration of therapy, and predictors of response are currently lacking. To assess the clinical response to and predictors of propranolol use in the treatment of IH. Retrospective cohort study of 44 patients. Two independent assessors evaluated improvement by comparing serial digital photographs using a 100 mm visual analogue scale (VAS), where 5 mm change represented 10% change in the size or appearance of the IH. Propranolol was started at a mean age of 7.8 (SD 8.21) months and was used for 7.3 (SD 4.8) months before weaning. The mean percent improvement compared to baseline (as measured by the VAS) was 78% (SD 23%). Minor adverse events were noted in 32% of patients. The most significant predictor of regrowth after weaning was a IH > 5 cm in size (p = .017). Propranolol is effective in IH, but the side effects and the possibility of regrowth should be consi...

Efficacy of propranolol in infantile hemangioma

Bangladesh Medical Journal Khulna, 2015

Hemangiomas, are the most common benign tumors of infancy. Despite their selflimited course, infantile capillary hemangiomas can cause local complications e.g. pain, ulceration, bleeding etc. The usual treatments include oral/intralesional steroids, alpha interferon, cytotoxins, pulsed dye laser and cosmetic surgery resection. These treatments are not free of multiple complications and toxic side effects. We report our experience with the use of propranolol in 2 children with haemangiomas along with review of relevant literature. Both the hemangioma cases promptly responded to low-dose oral propranolol. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22561 Bang Med J (Khulna) 2014; 47 : 32-35

The Efficacy and Safety of Propranolol in Treating Infantile Hemangioma: A Prospective Study

Iranian Journal of Pharmaceutical Research

Hemangiomas are benign vascular tumors that often develop in infants. The most common treatment option for complicated hemangiomas is propranolol. We discuss the use of oral propranolol in treating infantile hemangioma (IH) in an Iranian population at our hospital. We conducted a cross-sectional prospective descriptive study on 62 infants aged 1 to 16 months from 2017 to 2021. Propranolol was gradually administered orally at a dose of 3 mg/kg/day. The hemangioma score was examined at 6 intervals (first visit, 1, 3, 6, 9, and 12 months later). Propranolol therapies were stopped when there was no further decrease in scores for 2 successive visits. The study was completed by 62 patients. In terms of hemangiomas, 46 (74.2%) patients had 1 lesion, 12 (19.4%) had 2 lesions, and 4 (6.5%) had 3 lesions. Over time, the average size of hemangiomas steadily decreased, such that 5 patients (9.1%) were completely treated; 1 patient improved after 3 months, 3 after 6 months, 1 after 9 months, and 57 (91.9%) were partially treated. Aside from being safe and effective, propanol can also obtain a higher response rate when treatment is started early in infants aged less than 3 months.

Propranolol treatment for severe infantile hemangiomas: a single-centre 3-year experience

Acta Paediatrica, 2012

To evaluate the effectiveness, safety and tolerability of propranolol as singleagent treatment in patients with problematic, proliferative-phase, infantile hemangiomas (IHs). Methods: Oral propranolol was administered at a dose of 2 mg ⁄ kg ⁄ day to 28 children. Cardiologic evaluation was performed before treatment initiation. Hemodynamic variables and blood glucose levels were monitored during the first 24 h of treatment, while the children were hospitalized. Clinical response and tolerance were assessed every month, along with photographic documentation. Macroscopic regression was considered the reduction >90% in the size of the IHs. Results: Effects on colour and growth were observed within the first month in all cases. Twenty-four patients completed treatment after a mean duration of 7.56 months, and their hemangiomas were successfully regressed. Propranolol was administered again, with satisfactory results, in three patients (12.5%) because of hemangioma regrowth. Satisfactory response is noticeable in ongoing cases. Episodes of hypotension were noted in four patients. There were no treatment interruptions because of side effects. Conclusions: Propranolol, as first-line treatment, yielded excellent results with very good clinical tolerance and also seems to be effective in relapses. The optimal duration of the treatment remains to be defined by long-term observation.