Propranolol treatment for infantile hemangioma does not increase risk of childhood wheezing

Mei-Zahav, Meir; Blau, Hannah; Hoshen, Moshe; Zvulunov, Alex; Mussaffi, Huda; Prais, Dario; Stafler, Patrick; Steuer, Guy; Lapidoth, Moshe; Amitai, Dan Ben

doi:10.1002/ppul.23683

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…However, hypoglycemia events have often occurred during concurrent infection and/or fasting and can therefore be minimized with education of caregivers on the importance of administrating propranolol during or right after a feeding and temporary withdrawal of treatment during fasting or vomiting . Mei‐Zahav et al . recently reported that propranolol treatment for IH did not increase risk of childhood wheezing.…”

Section: Discussionmentioning

confidence: 99%

“…Incidence of respiratory episodes, recurrent respiratory episodes, time to first episode and respiratory hospital admission rate were similar in the propranolol and control groups. 25 We have to reconsider items to be monitored, because the closer the monitoring is, the more likely patients are hospitalized, and patients taking propranolol for tetralogy of Fallot are not monitored as strictly as patients taking propranolol for IH.…”

Section: Discussionmentioning

confidence: 99%

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Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Kagami

Kaneko

Katori

2018

The Journal of Dermatology

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Infantile hemangiomas undergo rapid growth during early infancy followed by gradual involution. Infantile hemangiomas sometimes impair vital functions or cause disfigurement. Thirty-two Japanese patients between the ages of 1 and 4 months with proliferating infantile hemangiomas received oral propranolol on an outpatient basis. The success rate (complete or nearly complete resolution) at week 25 was 56% (18/32). Two patients dropped out because of a personal reason and moving out. Recurrence after termination of treatment was seen in six patients. Adverse events occurred in 16 patients. There were no adverse events on day 1 (initiation of treatment at a dose of 1 mg/kg per day) and day 8 (dose increase to 2 mg/kg per day). One patient was hospitalized due to pneumonia, and suspended propranolol for 26 days. Oral propranolol at 2 mg/kg per day is effective and safe in Japanese patients with infantile hemangiomas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Kagami

Kaneko

Katori

2018

The Journal of Dermatology

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“…A recent cohort study suggested that propranolol did not significantly impair sleep quality and pattern 100. Although beta-blockers are generally contraindicated in the setting of reactive airway disease, propranolol does not appear to increase the risks of wheezing 101…”

Section: Treatmentmentioning

confidence: 99%

“…100 Although beta-blockers are generally contraindicated in the setting of reactive airway disease, propranolol does not appear to increase the risks of wheezing. 101 In patients with PHACE(S) syndrome, lowering the blood pressure in abnormal vasculature could increase the risk for stroke. The arterial vascular abnormalities which are present in PHACE(S) syndrome are heterogeneous, and the highest risk lesions are those that have long segment narrowing or incomplete or nonvisualization of the cerebral or cervical arteries.…”

Section: Treatmentmentioning

confidence: 99%

Infantile Hemangioma: A Current Review

Pahl

McLean

2021

Journal of Pediatric Hematology/Oncology

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Infantile hemangiomas (IHs) are common vascular lesions which are benign but can cause significant functional and cosmetic morbidity. Since the fortuitous discovery of propranolol being effective to treat IH over a decade ago, the therapy and prognosis for children with IH have improved dramatically. Oral propranolol (as well as other oral beta-blockers and topical timolol) are safe and effective treatments, and have now supplanted other therapies. Making the correct diagnosis is crucial, because other vascular lesions can mimic IH. In addition, IH can be the first manifestation of an underlying syndrome. For IH requiring treatment, initiating treatment early is key to optimizing success. Therefore, early recognition and referral, if necessary, are important. Continued research on IH, both basic science and clinical, should result in continued advances.

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Infantile Hemangioma: An Updated Review

Leung

Lam

Leung

et al. 2021

CPR

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Background: Infantile hemangiomas are the most common vascular tumors of infancy affecting up to 12% of infants by the first year of life. Objective: To familiarize physicians with the natural history, clinical manifestations, diagnosis, and management of infantile hemangiomas. Methods: A Pubmed search was conducted in November 2019 in Clinical Queries using the key term "infantile hemangioma". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: The majority of infantile hemangiomas are not present at birth. They often appear in the first few weeks of life as areas of pallor, followed by telangiectatic telangiectatic or faint red patches. They then grow rapidly in the first 3 to 6 months of life. Superficial lesions are bright red, protuberant, bosselated or with a smooth surface, and sharply demarcated. Deep lesions are bluish and dome-shaped. Infantile hemangiomas continue to grow until 9 to 12 months of age, at which time the growth rate slows down to parallel the growth of the child. Involution typically begins by the time the child is a year old. Approximately 50% of infantile hemangiomas will show complete involution by the time a child reaches age 5; 70% will have disappeared by age 7; and 95% will have regressed by 10 to 12 years of age. The majority of infantile hemangiomas require no treatment. Treatment options include oral propranolol, topical timolol, and oral corticosteroids. Indications for active intervention include hemorrhage unresponsive to treatment, impending ulceration in areas where serious complications might ensue, interference with vital structures, life- or function-threatening complications, and significant disfigurement. Conclusion: Treatment should be individualized, depending upon the size, rate of growth, morphology, number and location of the lesion (s), existing or potential complications, benefits and adverse events associated with the treatment, age of the patient, level of parental concern, and the physician's comfort level with the various treatment options. Currently, oral propranolol is the treatment of choice for high-risk and complicated infantile hemangiomas. Topical timolol may be considered for superficial infantile hemangiomas which need to be treated and for complicated infantile hemangiomas in patients at risk for severe adverse events from oral administration of propranolol.

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Propranolol treatment for infantile hemangioma does not increase risk of childhood wheezing

Abstract: Propranolol treatment does not exacerbate wheezing episodes in infants and children.

Cited by 3 publications

References 18 publications

Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Infantile Hemangioma: A Current Review

Infantile Hemangioma: An Updated Review

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