The efficacy of propranolol in very preterm infants at the risk of retinopathy of prematurity: Which newborn and when?

Öztürk, Mehmet; Korkmaz, Levent

doi:10.1007/s10792-018-1018-8

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…The difference among the studies can be a result of the difference among the number of the subjects that have had a need for more aggressive actions. 14,15 In this study, the only side effect has been one case of hypoglycemia in the third day of the cure (Bs = 35) in which the patient showed no sign of the hypoglycemia but he was let out of the study. In other similar studies including Makhoul and Aldo Bancalari studies, no side effects were seen.…”

Section: Discussionmentioning

confidence: 78%

“…The change of the retinopathy and the ocular areas of the disease in each study can be a reason for this, too. [11][12][13][14][15] Because of the patient's need for drug discontinuation and more aggressive therapies, drug consumption duration is different. In this study, the difference of the drug consumption duration between the group that has shown reactions to the cure and the group without reactions has shown significant, while in Ozturk MA study, the drug consumption duration has been a variable and there has not been a significant relation between the two groups, unlike our study.…”

Section: Discussionmentioning

confidence: 99%

“…You should pay attention that taking Propranolol can have its specific and important side effects, including hypotension, bradycardia in the patients, closure of the airways and hypoglycemia. [15][16][17]…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Oral Propranolol Effect on Retinopathy of Prematurity: Randomized Clinical Trial

Mirjalili¹,

Manaviat²,

Shadkam³

2020

WJPN

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Background: Despite rapid advances in neonatal care in both industrialized and developing countries, retinopathy of prematurity (ROP) still remains the main reason of infants' blindness and visual impairment. There is some evidence that Beta-adrenergic system may be involved in infants' ROP. Considering that few studies have been done on effects of oral propranolol on prevention retinopathy pre maturity in premature infants, we designed this clinical trial to investigate the effects of oral propranolol on infants. Methods: This study is a clinical trial in which 27 premature infants with gestational age greater than 27 weeks and afflicted with retinopathy pre maturity grade 1 and 2 hospitalized at Shahid Sadoughi hospital of Yazd city.They were randomized to receive 0.5 mg/kg/12hours oral propranolol or control. Premature infants were controlled and hospitalized at NICU and their BP, heart rate and Hyperemesis gravidarum (H.G) were monitored. Results: Twenty-four newborns were included, 12 in the control group and 12 in the propranolol group and 3 of infants were excluded from the study (2 of propranolol group and 1 of control group) 81.34 percent of treatment group were recovered and healed compared to 66.7 percent of control group which not significantly difference. Conclusion: Some studies about Beta Blockers' recessive effect on ROP have been done which in most recovery was the result but some serious side effects were also reported. In this study there was no positive effect on recovery of ROP but the percent of recovery was slightly higher in propranolol group compared to control group. Fortunately there were no reports of side effects this time due to usage of lower dose propranolol.Recent studies state that propranolol cannot be used as a good alternative to other treatments but it can prevent the disease from getting worse. We can also reduce its side effects by changing the dosage.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Oral Propranolol Effect on Retinopathy of Prematurity: Randomized Clinical Trial

Mirjalili¹,

Manaviat²,

Shadkam³

2020

WJPN

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“…Korkmaz et al demonstrated that the administration of propranolol in patients with stage 2 retinopathy significantly reduced the need for laser therapy, but there was no difference in the higher stages of retinopathy (25). Meanwhile, Ozturk and Korkmaz reported that propranolol administration in neonates with stage 2 retinopathy was effective in preventing progression to higher levels although it was not effective in reducing the risk of ROP in stages 0 and 1 (26). Based on the results of Bührer et al, the prophylaxis administration of propranolol did not lead to any difference in the risk of developing ROP in the neonates of the intervention group (27).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Oral Propranolol on the Treatment of Retinopathy of Prematurity

Hosseini

Gharehbaghi

Bagheri

et al. 2020

Crescent J Med Biol Sci

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Objectives: Due to recent advances in caring for premature neonates, premature retinopathy has become an important cause of preventable blindness and ocular disabilities. Therefore, more attention is paying to its diagnostic-therapeutic methods. Thus, the current trial assessed the efficacy of oral propranolol on the treatment of retinopathy of prematurity (ROP) in neonates. Materials and Methods: In the current trial, 58 neonates with ROP were included and the efficacy of oral propranolol (0.5 mg/kg every 8 hours) was compared with the control group. Results: In the intervention group, the stage of ROP was almost the same as the control group while 31.1% of neonates in the control group were progressed to stage 3. On the other hand, it was only 6.9% (P=0.009) in the intervention group. In patients receiving propranolol, only 2 cases required invasive therapeutic interventions whereas 9 patients required such interventions in the control group (P=0.009). The ROP improvement rate was significantly higher in the intervention group. In the control group, the overall progression to higher stages was about 48.3% while it was 13.8% for the intervention group. The mean age of neonates at the time of retinal artery completion was 91.40±22.16 and 128.08±79.89 days for the control and intervention groups, respectively (P=0.136). Conclusions: The results of this study showed that adding oral propranolol to standard therapy can reduce the rate of ROP progression to higher stages in preterm neonates with low birth weight, and the need for invasive treatments.

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“…Based on these preclinical studies, the efficacy and the safety of a treatment with propranolol, administered during the proliferative phase, was tested in human preterm newborns with ROP in a series of pilot clinical trials (Filippi et al, 2013;Makhoul et al, 2013;Bancalari et al, 2016;Korkmaz et al, 2017;Sanghvi et al, 2017;Sun et al, 2018;Ozturk and Korkmaz, 2019). Three recent meta-analyses demonstrated that oral administration of propranolol to newborns with ROP slows down the progression of retinal neovascularization and reduces the indication for laser photocoagulation or anti-VEGF drugs (Kaempfen et al, 2018;Stritzke al., 2019;Kong et al, 2021).…”

Section: Treatment With Propranololmentioning

confidence: 99%

Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors

et al. 2022

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Retinopathy of prematurity (ROP) is an evolutive and potentially blinding eye disease that affects preterm newborns. Unfortunately, until now no conservative therapy of active ROP with proven efficacy is available. Although ROP is a multifactorial disease, premature exposition to oxygen concentrations higher than those intrauterine, represents the initial pathogenetic trigger. The increase of oxygenation in a retina still incompletely vascularized promotes the downregulation of proangiogenic factors and finally the interruption of vascularization (ischemic phase). However, the increasing metabolic requirement of the ischemic retina induces, over the following weeks, a progressive hypoxia that specularly increases the levels of proangiogenic factors finally leading to proliferative retinopathy (proliferative phase). Considering non-modifiable the coupling between oxygen levels and vascularization, so far, neonatologists and ophthalmologists have “played defense”, meticulously searching the minimum necessary concentration of oxygen for individual newborns, refining their diagnostic ability, adopting a careful monitoring policy, ready to decisively intervene only in a very advanced stage of disease progression. However, recent advances have demonstrated the possibility to pharmacologically modulate the relationship between oxygen and vascularization, opening thus the perspective for new therapeutic or preventive opportunities. The perspective of a shift from a defensive towards an attack strategy is now at hand.

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The efficacy of propranolol in very preterm infants at the risk of retinopathy of prematurity: Which newborn and when?

Abstract: When given in the neovascularization phase of the ROP, propranolol was found to be effective in the stage 2 (advanced stage) ROP patients but in stage 0-1 (early-stage) ROP patients, its efficacy was not sufficient.

Cited by 8 publications

References 29 publications

Evaluation of the Oral Propranolol Effect on Retinopathy of Prematurity: Randomized Clinical Trial

Evaluation of the Oral Propranolol Effect on Retinopathy of Prematurity: Randomized Clinical Trial

Efficacy of Oral Propranolol on the Treatment of Retinopathy of Prematurity

Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors

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