Effectiveness, Indications, and Side Effects of Oral Propranolol Treatment for Infantile Hemangioma in Japanese Patients

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

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Propranolol treatment for infantile hemangioma: a case series of sixty-two patients

La Pediatria Medica e Chirurgica ◽

10.4081/pmc.2016.113 ◽

2016 ◽

Vol 38 (2) ◽

Cited By ~ 4

Author(s):

Giovanna Stringari ◽

Giulia Barbato ◽

Matteo Zanzucchi ◽

Maddalena Marchesi ◽

Giuseppe Cerasoli ◽

...

Keyword(s):

Case Series ◽

Severe Hypoglycemia ◽

Infantile Hemangioma ◽

Treatment Length ◽

Endoscopic Findings ◽

Life Threatening ◽

Propranolol Treatment ◽

The Mean ◽

The Impact ◽

Oral Propranolol

Infantile hemangiomas (IH) complicated by ulceration, disfigurement, functional impairment or life-threatening conditions need early, safe and effective treatment. This study explores the impact of propranolol on complicated IH. We report our experience of 62 patients treated with oral propranolol for complicated IH. The effect of propranolol was assessed using a score on a visual analogue scale integrated with echo, magnetic resonance or endoscopic findings. The average age at the beginning of the treatment was seven months [standard deviation (SD)±8.9], with a median of four months (range 1-53 months). The average age at the end of the treatment was 15 months (SD±8.4), with a median of 13 months (range 7-59 months). The mean treatment length was eight months (SD±3.2). Oral propranolol was successful in 95.2% of the patients in reducing the volume, the intensity of color and the elevation of IH. Statistically significant improvement of IH volume was observed in the first two months of therapy (P≤0.001), and between the second month and the end of the treatment (P<0.05). No significant bradycardia or hypotension occurred. Severe hypoglycemia occurred in one patient. Mild adverse effects were observed in seven patients. Our study demonstrates that propranolol administered orally at 2 to 3 mg/kg/day has a rapid therapeutic effect leading to remarkable shortening of the natural course of IH and it is safe in the majority of patients.

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Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children

Dermatology Research and Practice ◽

10.1155/2014/541810 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Basheir A. Hassan ◽

Khalid S. Shreef

Keyword(s):

Side Effects ◽

Prospective Clinical Study ◽

Egyptian Children ◽

Propranolol Treatment ◽

Promising Treatment ◽

The Mean ◽

Benign Tumours ◽

Propranolol Therapy ◽

Oral Propranolol

Background. Infantile hemangiomas (IHs) are the most common benign tumours of infancy. Propranolol has recently been reported to be a highly effective treatment for IHs. This study aimed to evaluate the efficacy and side effects of propranolol for treatment of complicated cases of IHs.Patients and Methods. This prospective clinical study included 30 children with huge or complicated IHs; their ages ranged from 2 months to 1 year. They were treated by oral propranolol. Treatment outcomes were clinically evaluated.Results. Superficial cutaneous hemangiomas began to respond to propranolol therapy within one to two weeks after the onset of treatment. The mean treatment period that was needed for the occurrence of complete resolution was 9.4 months. Treatment with propranolol was well tolerated and had few side effects. No rebound growth of the tumors was noted when propranolol dosing stopped except in one case.Conclusion. Propranolol is a promising treatment for IHs without obvious side effects. However, further studies with longer follow-up periods are needed.

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Prolonged growth of infantile hemangioma after pulsed dye laser and oral propranolol treatment

The Journal of Dermatology ◽

10.1111/1346-8138.14517 ◽

2018 ◽

Vol 45 (9) ◽

pp. 1109-1112 ◽

Cited By ~ 1

Author(s):

Shinji Kagami ◽

Masahide Kaneko ◽

Akiko Kishi ◽

Tatsuo Katori

Keyword(s):

Infantile Hemangioma ◽

Dye Laser ◽

Pulsed Dye Laser ◽

Propranolol Treatment ◽

Oral Propranolol

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Role of propranolol in the management of infantile hemangioma

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194319 ◽

2019 ◽

Vol 7 (10) ◽

pp. 3839 ◽

Cited By ~ 1

Author(s):

Manwendra Kumar ◽

Sudhir Kumar ◽

Pankaj K. Chaudhary ◽

Amit Kumar

Keyword(s):

Skin Color ◽

Infantile Hemangioma ◽

Age Group ◽

Medical College ◽

Infancy And Childhood ◽

Benign Soft Tissue Tumor ◽

Propranolol Treatment ◽

Almost All ◽

Oral Propranolol

Background: Infantile hemangiomas are the most common benign soft tissue tumor of infancy and childhood occurring 4-10% of all infants. It is more frequent in premature children (23% of infants <1200g) and females (3:1 to 5:1). For many hemangiomas treatment is not required, however hemangioma in some locations need treatment to prevent complication. The Present study was done with an Aim to assess the efficacy and safety of oral Propranolol in management of infantile heamangioma in our set-up.Methods: This study was conducted from May 2016 to Nov 2017 at Department of Surgery and Pediatrics, M.L.B. Medical College, Jhansi after obtaining Ethical permission. Patients having confirmed were recruited & admitted for initiation of Oral Propranolol therapy for 5 days under the observation of Paediatrician. Oral Propranolol treatment was continued till the age of 11/2 years. A clinical assessment was made at each visit to the Outpatients Clinic every four weeks.Results: The incidences of infantile hemangioma were more in age group (0-7 months) i.e 55% (22 patients) followed by age group of (8-15 days) i.e. 30% (12 patients). As age advances presentation gradually decreases as after 30 days incidence is only 5%. Infantile hemangioma were more common in females’ patients (55% patients) & mostly 90% (36 patients) present as single lesion and only 10% (4 patients) present as multiple lesions. Most of hemangiomas presented as reddish in color 80% (32 patients) which reflected lesions are mostly superficial & only 10% were brownish red and 10% skin color indicated incidence of deeper penetration.Conclusion: Authors found that drug (Propranolol) to be effective even at low dose of 1mg/kg/day. In our study group it was effective and safe in almost all patients.

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Treatment of infantile haemoangioma – Update 2016

Phlebologie ◽

10.12687/phleb2322-4-2016 ◽

2016 ◽

Vol 45 (04) ◽

pp. 194-200

Author(s):

A. Mangatter ◽

P. Ruef

Keyword(s):

Side Effects ◽

Topical Treatment ◽

Systemic Treatment ◽

Infantile Hemangioma ◽

Serum Levels ◽

Arterial Blood ◽

Paediatric Patients ◽

Propranolol Treatment ◽

Insight Into ◽

Systemic Drug

Summary Aim Complicated infantile hemangioma need early, safe and effective treatment. The aim of this study was to provide greater insight into systemic and topical propranolol treatment efficacy and side effects. Methods We report our retrospective experiences of 207 paediatric patients treated with systemic propranolol and of 148 paediatric patients treated with propranolol gel topically photographed and analysed with a specific hemangioma score. Results Propranolol treatment was successful in >99 % of the patients. The hemangioma score showed a significant decrease during systemic treatment (8.3 ± 3.3 at beginning and 1.5± 1.4 after 6 months) and during topical treatment (4.2 ± 1,6 at beginning and 2.2 ± 1.3 after three months). Systemic treatment did not show any differences when distributed according to different localizations or to the patient`s ages. During topical propranolol treatment relevant serum levels were not determined. Relevant side effects that may have made it necessary to discontinue the treatment were not observed. However, there was a statistically significant reduction in heart rate but not in mean arterial blood pressure during the first six in-hospital systemic drug applications. Conclusion Systemic propranolol treatment is highly effective and nearly always safe. Topical treatment with propranolol gel (off-label) is suitable for specific hemangioma in addition to cryotherapy and systemic treatment with propranolol. These findings provide highly valuable information on this drug treatment for complicated infantile hemangioma in infants.

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