Effects of systemic propranolol treatment on physical growth of patients with infantile hemangiomas

Abstract

Propranolol has been widely used in the treatment of infantile hemangiomas since 2008. This study aimed to investigate complications of systemic propranolol therapy for infantile hemangiomas, especially its effect on infants' physical growth. In this study, propranolol was given at a dose of 2 mg/kg per day. Abnormal symptoms and growth parameters were recorded in detail during the therapy. Follow-up visits were arranged to continue at least through the age of 2 years. A total of 76 patients with complete growth parameters were enrolled into the study. Complications of propranolol were minor, and mainly included sleeping disorders, diarrhea, decrease in fasting glucose, bronchial hyperactivity and hyperkalemia. Four (5.26%) patients' growth curve dropped off more than 20 percentiles during therapy and half of them returned to normal after withdrawal of the medications. None of them suffered from underweight, wasting or stunning when medication was stopped. Systemic propranolol was proved to be a safe treatment for problematic infantile hemangiomas and did not affect the physical growth.

Refractive Outcome in Preterm Newborns With ROP After Propranolol Treatment. A Retrospective Observational Cohort Study

“…Regarding physical growth, that was comparable between both groups at birth, no difference of anthropometric parameters was observed at 1 year of age between the group that received propranolol and the CG, confirming the data already reported for infants treated with propranolol for infantile hemangiomas (34).…”

A 7‐year follow‐up study on untreated deep or mixed facial infantile hemangioma in East‐Asian patients: When propranolol was not yet an option

“…Propranolol was first introduced for off-label use on IH in 2008 and has since been reported safe and effective for the treatment of IH. 8,9 To date, there are different modalities of treatments for problematic IHs, such as intralesional injection, topical beta blockers, and laser treatments, etc. However, most physicians adopted the wait-and-see method and waited for the tumor to spontaneously involute before the propranolol era.…”

“…Propranolol was first introduced for off‐label use on IH in 2008 and has since been reported safe and effective for the treatment of IH . To date, there are different modalities of treatments for problematic IHs, such as intralesional injection, topical beta blockers, and laser treatments, etc.…”

Contact Dermatitis

“…It is unknown what causes weight loss in such cases. 2 Although uncommon, this case suggests monitoring of cognition and developmental changes in children whilst on propranolol for IH is needed. The possibility of such reactions and weight-loss should be included in information provided to parents when starting their child on propranolol, so they can watch for any concerning changes.…”

“…1 Uncommonly reported instances of reversible weight-loss, cognition and developmental change, including decline or delay in walking, whilst taking propranolol do exist. 2 We report another such case of weight-loss and central nervous system (CNS) effects of behaviour change, lethargy and decline in cognitive and functional development in a nine-month-old girl taking oral propranolol for IH. She regained her prior level of activity, cognitive function and development within weeks of propranolol cessation and slowly regained weight.…”