Propranolol-resistant infantile haemangiomas

Abstract

Summary Backround Propranolol is now widely used to treat severe infantile haemangiomas (IHs). Very few cases of propranolol‐resistant IH (PRIH) are mentioned in the literature. Objectives To describe the characteristics of PRIHs. Methods A national, multicentre, retrospective, observational study was conducted from February 2011 to December 2011. All patients with PRIH evaluated by the members of the Groupe de Recherche Clinique en Dermatologie Pédiatrique from 1 January 2007 to 1 December 2011 were eligible. Results Among 1130 patients treated with propranolol for infantile haemangioma, 10 (0·9%) had PRIHs. Haemangioma propranolol resistance was observed at all ages during early childhood and at any proliferation stage. Conclusions PRIH is a rare phenomenon that raises questions and merits further investigation.

Therapeutic superiority of combined propranolol with short steroids course over propranolol monotherapy in infantile hemangioma

“…The reported success rate from a systematic review and meta-analysis for all published series demonstrated an overall response rate of 97 % among patients treated with propranolol for infantile hemangioma versus a pooled response of 69 % for corticosteroids studies [8]; 0.9 % had propranolol-resistant infantile hemangiomas. Resistance was observed at all ages during early childhood and at any proliferation stage [3].…”

“…However, Malik et al reported an earlier response in a small group of patients treated with propranolol either monotherapy or combined with corticosteroids compared to steroids monotherapy [13]. Dual therapy with short steroids course could overcome propranolol resistance estimated in a previous study to be of 0.9 % [3].…”

Wnt3a Expression is Associated with MMP-9 Expression in Primary Tumor and Metastatic Site in Recurrent or Stage IV Colorectal Cancer

“…β-blockers have recently been introduced as a safe and effective treatment for IH [8][9][10][11]. However, their use is not without risk, and not all tumors respond to these drugs [12,13]. These issues have spurred extensive research to clarify the signaling pathways implicated in hemangioma neovascularization in the hope that a greater understanding of its molecular pathogenesis will reveal new strategies to tackle IH.…”

Open airway surgery for subglottic hemangioma in the era of propranolol: Is it still indicated?

“…Propanolol-resistant infantile hemangiomas have been previously described, although rarely, and one study showed an incidence of 0.9% propranolol resistance among 1130 cutaneous hemangiomas [16]. Our experience suggests that the rate of propranolol resistance may be higher in subglottic hemangioma than cutaneous hemangioma, however further studies would be needed to substantiate this finding as well as to determine the mechanism for why subglottic hemangiomas are less responsive.…”