Journal ArticleDOI
A Randomized Controlled Trial of Propranolol for Infantile Hemangiomas
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TLDR
Propranolol hydrochloride administered orally at 2 mg/kg per day reduced the volume, color, and elevation of focal and segmental IH in infants younger than 6 months and children up to 5 years of age.Abstract:
OBJECTIVE: Propranolol hydrochloride is a safe and effective medication for treating infantile hemangiomas (IHs), with decreases in IH volume, color, and elevation. METHODS: Forty children between the ages of 9 weeks and 5 years with facial IHs or IHs in sites with the potential for disfigurement were randomly assigned to receive propranolol or placebo oral solution 2 mg/kg per day divided 3 times daily for 6 months. Baseline electrocardiogram, echocardiogram, and laboratory evaluations were performed. Monitoring of heart rate, blood pressure, and blood glucose was performed at each visit. Children younger than 6 months were admitted to the hospital for monitoring after their first dose at weeks 1 and 2. Efficacy was assessed by performing blinded volume measurements at weeks 0, 4, 8, 12, 16, 20, and 24 and blinded investigator scoring of photographs at weeks 0, 12, and 24. RESULTS: IH growth stopped by week 4 in the propranolol group. Significant differences in the percent change in volume were seen between groups, with the largest difference at week 12. Significant decrease in IH redness and elevation occurred in the propranolol group at weeks 12 and 24 (P = .01 and .001, respectively). No significant hypoglycemia, hypotension, or bradycardia occurred. One child discontinued the study because of an upper respiratory tract infection. Other adverse events included bronchiolitis, gastroenteritis, streptococcal infection, cool extremities, dental caries, and sleep disturbance. CONCLUSION: Propranolol hydrochloride administered orally at 2 mg/kg per day reduced the volume, color, and elevation of focal and segmental IH in infants younger than 6 months and children up to 5 years of age.read more
Citations
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Journal ArticleDOI
A Randomized, Controlled Trial of Oral Propranolol in Infantile Hemangioma
Christine Léauté-Labrèze,Peter H. Hoeger,Juliette Mazereeuw-Hautier,Laurent Guibaud,Eulalia Baselga,Gintas Posiunas,Roderic J Phillips,Héctor Cáceres,Juan Carlos López Gutiérrez,Rosalia Ballona,Sheila Fallon Friedlander,Julie Powell,Danuta Perek,Brandie J. Metz,Sébastien Barbarot,Annabel Maruani,Zsuzsanna Szalai,Alfons Krol,Olivia Boccara,Regina Foelster-Holst,María Isabel Febrer Bosch,John C Su,Hana Buckova,Antonio Torrelo,Frédéric Cambazard,Rainer Grantzow,Orli Wargon,Dariusz Wyrzykowski,Jochen Roessler,Jose Bernabeu-Wittel,Adriana M Valencia,Przemysław Przewratil,Sharon A. Glick,Elena Pope,Nicholas Birchall,Latanya Benjamin,Anthony J. Mancini,Pierre Vabres,Pierre Souteyrand,Ilona J. Frieden,Charles I Berul,Cyrus R. Mehta,Sorilla Prey,Franck Boralevi,Caroline C. Morgan,Stephane Heritier,Alain Delarue,Jean-Jacques Voisard +47 more
TL;DR: This trial showed that propranolol was effective at a dose of 3 mg per kilogram per day for 6 months in the treatment of infantile hemangioma.
Journal ArticleDOI
Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference
Beth A. Drolet,Peter C. Frommelt,Sarah L. Chamlin,Anita N. Haggstrom,Nancy M. Bauman,Yvonne E. Chiu,Robert H. Chun,Maria C. Garzon,Kristen E. Holland,Leonardo Liberman,Susan G. MacLellan-Tobert,Anthony J. Mancini,Denise W. Metry,Katherine B. Puttgen,Marcia Seefeldt,Robert Sidbury,Kendra M. Ward,Francine Blei,Eulalia Baselga,Laura D. Cassidy,David H. Darrow,Shawna Joachim,Eun Kyung M. Kwon,Kari Martin,Jonathan A. Perkins,Dawn H. Siegel,Robert J. Boucek,Ilona J. Frieden +27 more
TL;DR: The multidisciplinary team agreed on a number of recommendations that arose from a review of existing evidence, including when to treat complicated IH; contraindications and pretreatment evaluation protocols; propranolol use in PHACE syndrome; formulation, target dose, and frequency of proPRanolol; initiation of propr ethanol in infants; cardiovascular monitoring; ongoing monitoring; and prevention of hypoglycemia.
Journal ArticleDOI
Propranolol and infantile hemangiomas four years later: a systematic review.
TL;DR: A systematic review of 1,264 patients treated with propranolol for IHs showed a high rate of efficacy and a low rate of serious adverse events.
Journal ArticleDOI
Diagnosis and Management of Infantile Hemangioma.
TL;DR: This clinical report is the first based on input from individuals representing the many specialties involved in the treatment of IH to update the pediatric community regarding recent discoveries in IH pathogenesis, treatment, and clinical associations and to provide a basis for clinical decision-making in the management of Ih.
Journal ArticleDOI
Infantile Hemangiomas: An Update on Pathogenesis and Therapy
TL;DR: New modalities, such as oral propranolol, provide the caregiver with better therapeutic options, which can prevent or minimize medical risk or scarring, but the side effect profile and risk-benefit ratio of such interventions must always be evaluated before instituting therapy.
References
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Journal ArticleDOI
Propranolol for Severe Hemangiomas of Infancy
Christine Léauté-Labrèze,Dumas de la Roque E,Thomas Hubiche,Franck Boralevi,Thambo Jb,Alain Taieb +5 more
TL;DR: It is observed in 11 children that propranolol can inhibit the growth of infantile capillary hemangiomas and this work is hopeful that this discovery will help improve the prognosis of these patients.
Journal ArticleDOI
Growth Characteristics of Infantile Hemangiomas: Implications for Management
Linda C. Chang,Anita N. Haggstrom,Beth A. Drolet,Eulalia Baselga,Sarah L. Chamlin,Maria C. Garzon,Kimberly A. Horii,Anne W. Lucky,Anthony J. Mancini,Denise W. Metry,Amy J. Nopper,Ilona J. Frieden +11 more
TL;DR: Most infantile hemangioma growth occurs before 5 months, yet 5 months was also the mean age at first visit to a specialist, and recognition of growth characteristics and factors that predict the need for follow-up could help aid in clinical decision-making.
Journal ArticleDOI
Propranolol for Severe Infantile Hemangiomas: Follow-Up Report
Veronique Sans,Eric Dumas De La Roque,Jérôme Berge,Nicolas Grenier,Franck Boralevi,Juliette Mazereeuw-Hautier,Dan Lipsker,Elisabeth Dupuis,Khaled Ezzedine,P. Vergnes,Alain Taieb,Christine Léauté-Labrèze +11 more
TL;DR: Propranolol administered orally at 2 to 3 mg/kg per day has a consistent, rapid, therapeutic effect, leading to considerable shortening of the natural course of IHs, with good clinical tolerance.
Journal ArticleDOI
Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action.
C.H. Storch,Peter H. Hoeger +1 more
TL;DR: Oral propranolol is a very recent therapeutic option for complicated IH with impressive efficacy and generally good tolerance, and its mechanisms of action in IH are presented.
Journal ArticleDOI
Oral Corticosteroid Use Is Effective for Cutaneous Hemangiomas: An Evidence-Based Evaluation
TL;DR: Systemic corticosteroid treatment seems to be effective for problematic cutaneous hemangiomas of infancy and the relationship of dose to response and adverse effects is assessed.
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Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference
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A Randomized, Controlled Trial of Oral Propranolol in Infantile Hemangioma
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