Propranolol for infantile haemangiomas: review of report of a consensus conference

Biesbroeck, Lauren K.; Brandling‐Bennett, Heather A.

doi:10.1136/archdischild-2013-305027

Cited by 11 publications

(5 citation statements)

References 6 publications

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“…The efficacy rate was 99.5%. We confirm other studies already published that showed an efficacy rate around 97% . Our study contains the largest patient collective yet published and, for the first time, we analysed all haemangiomas with a standardised haemangioma score (Table ).…”

Section: Discussionsupporting

confidence: 86%

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A retrospective analysis of systemic propranolol for the treatment of complicated infantile haemangiomas

2014

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Aim: A small percentage of complicated infantile haemangiomas need early, safe and effective treatment, and the option of off-label systemic propranolol treatment has been in existence since 2008. The aim of this study was to provide greater insight into the drug's efficacy and side effects.Methods: We report our retrospective experiences of 207 paediatric patients treated with systemic propranolol for complicated infantile haemangiomas, which were photographed and analysed with a specific haemangioma score.Results: Systemic treatment was successful in 99.5% of the patients. The haemangioma score before treatment was 8.3 AE 3.3 and the score at the end of the treatment was 1.5 AE 1.4. The reduction in the haemangiomas was significant and did not show any differences when distributed according to different localisations or to the patients' ages. 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 during the first six in-hospital drug applications. Conclusion:Our study demonstrates that systemic propranolol treatment is a highly effective treatment that is nearly always safe. These findings are a milestone for particularly complicated haemangiomas and provide highly valuable information on this drug treatment.

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Section: Discussionsupporting

confidence: 86%

“…The duration of the active treatment with systemic propranolol differs between one and 16 months in the actual literature . Our mean average treatment duration was 29.3 weeks (±19.2 weeks SD), lying in the middle of this time range.…”

Section: Discussionmentioning

confidence: 77%

A retrospective analysis of systemic propranolol for the treatment of complicated infantile haemangiomas

2014

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“…2 Current FDA prescribing information for Hemangeol™ and provisional consensus guidelines recommend monitoring heart rate (HR) and blood pressure (BP) after the first and second hours following propranolol initiation and after each dose increase. 1,6,7 However, actual initiation and titration practices differ among providers and…”

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confidence: 99%

Is prolonged monitoring necessary? An updated approach to infantile hemangioma treatment with oral propranolol

Johansen

Mahendran

Lawley

2021

Pediatric Dermatology

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Infantile hemangiomas (IH) are the most common soft-tissue tumors in childhood, occurring in up to 10% of infants. 1,2 The majority of these benign vascular tumors require no treatment; however, in at least 12% of patients, they can become problematic, and depending on their anatomic location and extent of growth, require clinical evaluation and treatment. 1,3,4 In these cases, oral propranolol has emerged as a first-line treatment. 5 While the efficacy of propranolol as a treatment has been well supported through many studies, substantial variability in administration protocols remains. 2 Current FDA prescribing information for Hemangeol™ and provisional consensus guidelines recommend monitoring heart rate (HR) and blood pressure (BP) after the first and second hours following propranolol initiation and after each dose increase. 1,6,7 However, actual initiation and titration practices differ among providers and

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“…We reported that there were statistically significant reductions in HR and SBP measurements but there was no significant decrease in the mean of DBP. 11,24,25 . A survey by Kumar et al showed that only 25 percent of physicians carry out the following suggested guidelines exactly 26 .…”

Section: Discussionmentioning

confidence: 99%

Cardiac screening in patients with infantile hemangiomas before propranolol treatment

TURAN,

AYDİN KÖKER

2023

Cukurova Medical Journal

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Purpose: The aim of this study is to evaluate the cardiac findings of patients with Infantile hemangiomas (IH) prior to propronalol treatment and to compare our findings with literature data and verify the need for detailed cardiac screening. Materials and Methods: We performed a single-center retrospective review of patients diagnosed with IH who underwent cardiac screening between October 2021 and October 2022. Charts were reviewed and symptoms, heart rate, blood pressure, electrocardiogram, and echocardiogram findings were recorded for each patient. Results: Of the 50 patients, 30 were female. The mean age and weight were 7.1±7.3 months and 7.6±3.0 kg. Electrocardiography screening did not reveal any contraindication for treatment. Propranolol significantly reduced heart rate and systolic blood pressure (baseline: 120.2±10.5 bpm/89.6±17.6 mmHg; 1st week: 118.5±10.4 bpm/88.7±17.5 mmHg; 2nd week: 117.8±9.5 bpm/88.7±17.3 mmHg; 2nd month: 116.5±9.4 bpm/88.6±17.3 mmHg). Diastolic pressure reduction was significant only between ‘baseline- 1st week and ‘baseline- 2nd month (58.9±15.6 vs 58.2±15.8 mmHg; 58.9±15.6 vs 57.9±15.5 mmHg, respectively). Conclusion: Screening electrocardiography and hospitalization for initiation of propranolol therapy is not necessary in most infants. Given the low frequency of complications, it seems medical history and physical examination are the cornerstones for safe initiation and monitoring of β-blocker treatment. Electrocardiography and BP control should be part of the pretreatment evaluation in high-risk patients.

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Propranolol for infantile haemangiomas: review of report of a consensus conference

Cited by 11 publications

References 6 publications

A retrospective analysis of systemic propranolol for the treatment of complicated infantile haemangiomas

A retrospective analysis of systemic propranolol for the treatment of complicated infantile haemangiomas

Is prolonged monitoring necessary? An updated approach to infantile hemangioma treatment with oral propranolol

Cardiac screening in patients with infantile hemangiomas before propranolol treatment

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