Early propranolol treatment of infantile hemangiomas improves outcome

Giachetti, Ana; Díaz, María Sol; Boggio, Paula; Posadas‐Martinez, María Lourdes

doi:10.1016/j.abd.2022.04.008

Cited by 3 publications

(2 citation statements)

References 14 publications

(20 reference statements)

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“…A dose of 3 mg/kg/d is superior to 1 mg/kg/d, 9 but little data exist comparing 2 to 3 mg/kg/d 14 In fact, doses of 2.5 to 3 mg/kg/d may increase toxicity without added benefit 12,22,23 . Early initiation of propranolol (before 10 to 12 wk of age) improves outcomes compared with an older age of initiation 24,25 . Current literature suggests that propranolol is effective and well tolerated in infants younger than 5 weeks corrected gestational age 26 .…”

Section: Discussionmentioning

confidence: 99%

“…12,22,23 Early initiation of propranolol (before 10 to 12 wk of age) improves outcomes compared with an older age of initiation. 24,25 Current literature suggests that propranolol is effective and well tolerated in infants younger than 5 weeks corrected gestational age. 26 Depending on response, most experts recommend continuing propranolol until age 12 months, and sometimes longer.…”

Section: Discussionmentioning

confidence: 99%

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Practice Variations in Managing Infantile Hemangiomas

McLean,

Borst,

Hammill

et al. 2023

Journal of Pediatric Hematology/Oncology

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Infantile hemangioma (IH) is the most common benign tumor of infancy. For children with IH who require treatment, propranolol and other beta blockers have been shown to be safe and effective. Although consensus guidelines for managing IH have been published, anecdotal experience suggests that there remain variations in management. This study was performed to document these variations amongst providers and to identify areas for future research. We conducted an Internet-based survey of clinicians who treat patients with IH. Hypothetical cases and management scenarios were presented. Twenty-nine respondents participated in the survey. Most respondents use generic propranolol in infants with growing IH of the head and neck, with a goal dose of 2 mg/kg/d, until ~1 year of age. A variety of management strategies were documented including which patients should be treated, optimal dose and duration of therapy, how patients should be monitored, which patients should get additional workup, how propranolol should best be discontinued, and how often to see patients in follow-up. This study demonstrates wide practice variations in managing patients with IH. Further research is indicated to address these variations and develop additional/updated evidence-based guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Practice Variations in Managing Infantile Hemangiomas

McLean,

Borst,

Hammill

et al. 2023

Journal of Pediatric Hematology/Oncology

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Anticancer effect of propranolol on diethylnitrosamine‐induced hepatocellular carcinoma rat model

Tamim,

Nagy,

Abdellah

et al. 2024

Fundamemntal Clinical Pharma

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BackgroundHepatocellular carcinoma (HCC) is the most widespread type of primary liver cancer. Diethylnitrosamine (DEN), a hepatotoxic hepatocarcinogenic compound, is used to induce HCC in animal models. The non‐selective β‐blocker propranolol demonstrated antiproliferative activity in many cancer types.ObjectiveThis investigation aimed to evaluate the anticancer effect of propranolol against DEN‐induced HCC in rats.MethodsThirty adult male rats were divided into the following groups: Group I (C, control), Group II (HCC); received DEN, 70 mg/kg body weight (b.wt.) once a week for 10 weeks, to induce HCC, and Group III (HCC/Prop); received DEN for 10 weeks for HCC induction, then received 20 mg/kg b.wt. propranolol, intraperitoneally for four successive weeks.ResultsHCC was developed in rats' livers and confirmed via significant liver architecture changes, significantly elevated activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), α‐fetoprotein (AFP), total‐ and direct‐bilirubin (Bil), and a decline in albumin (ALB) level in serum. HCC group demonstrated elevated levels of malondialdehyde (MDA), nitric oxide (NO), HIF‐1α, IL‐8, NF‐κB, PGE2, TGF‐β1, VEGF, and CD8, but significant decline of GSH, and IL‐10 level, with suppression of the antioxidant enzymes' activities. In addition, the gene expression of the hepatic inducible nitric oxide synthase (iNOS), and LAG‐3 were up‐regulated. Moreover, the protein expression of p‐PKC was up‐regulated, while that of PD‐1 and PD‐L1 were down‐regulated in the liver tissues of the HCC group. However, propranolol ameliorated the investigated parameters in the HCC/Prop group.ConclusionPropranolol exhibited an anticancer effect and thus can be considered as a promising treatment for HCC. Blocking of PD‐1/PD‐L1 and LAG‐3 signals participated in the anti‐tumor effect of propranolol on HCC.

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Infantile Hemangiomas of the Head and Neck: A Single-Center Experience

Kizmazoglu,

Ince,

Olgun

et al. 2024

Children

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Background: Infantile hemangiomas (IHs) are the most common benign vascular tumors of infancy. Methods: We report our experiences with 248 patients with head and neck IHs. Results: The median admission age was 4 months, and the female/male ratio was 2.18. Among the cases, 45% were followed by no treatment. No local complications were observed in any of these patients. Propranolol was provided to all patients who received medical treatment. The median duration of treatment was 12 months (1–30 months), and the median follow-up period of all patients was 14 months (0–118 months). The treatment response was 98%. The complication rate was 17%, and children aged between 3 and 9 months accounted for 60% of the patients who developed complications. Most of the complications were local complications, such as ulceration and bleeding. Conclusions: Although most IHs regress spontaneously, complications may occur. Propranolol alone is an effective treatment option, and early treatment initiation increases the success rate.

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Early propranolol treatment of infantile hemangiomas improves outcome

Cited by 3 publications

References 14 publications

Practice Variations in Managing Infantile Hemangiomas

Practice Variations in Managing Infantile Hemangiomas

Anticancer effect of propranolol on diethylnitrosamine‐induced hepatocellular carcinoma rat model

Infantile Hemangiomas of the Head and Neck: A Single-Center Experience

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