Therapeutic Effect of Propranolol in Mexican Patients with Infantile Hemangioma

Castaneda, Saul; Garcia, Esbeydy; Cruz, Hermelinda De la; Ramírez, Óscar; Melendez, Samuel; Sanchez-Palacio, Jose

doi:10.1007/s40801-015-0052-3

Cited by 12 publications

(13 citation statements)

References 20 publications

(28 reference statements)

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“…Location of the lesion was noted to be a significant factor affecting the therapeutic outcome in this study. Similar to some previous reports,[1617] the outcomes were better for the lesions in the head and neck region. The statistical analyses here revealed favorable responses that were uniformly higher at every stage (the mean percentage reduction at 6 months being 71.8 ± 12.6 for the head and neck group against 51.7 ± 11.3 for the other sites).…”

Section: Discussionsupporting

confidence: 90%

Oral propranolol in infantile hemangiomas: Analysis of factors that affect the outcome

Ainipully

Narayanan

Vazhiyodan

et al. 2019

J Indian Assoc Pediatr Surg

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Aim: The primary treatment for the subset of infantile hemangiomas (IHs) which develops complication is pharmacological intervention, and propranolol has become a popular choice. Here, we evaluated the efficacy and safety of propranolol in a clinical cohort of IHs and analyzed clinical characteristics associated with a good outcome. Materials and Methods: We retrospectively reviewed a total of 52 IHs patients, between ages 1 and 48 months (median age: 7.5 months), who were treated with oral propranolol, with dose ranging from 2 to 3 mg/kg/day. Efficacy was evaluated using mean percentage reduction, visual analog scale (VAS), and parental satisfaction levels at week 2 and months 1, 2, 6, and 12. The adverse effects were noted and responses after 6 months were graded. Statistical analyses of the outcome were also performed for the responses with regard to age at propranolol initiation, site of lesion, and mean duration of treatment. Results: A therapeutic response with at least 50% mean percentage reduction in size was noted in 84.6% at the end of 6 months. VAS score and parental satisfaction levels correlated well with mean percentage reduction (63.7 ± 15.6) at 6 months. Patients aged <6 months and those with cephalic lesions exhibited a greater therapeutic response rate with shorter overall mean duration of the treatment. Conclusions: Oral propranolol at 2–3 mg/kg/day dosing has shown to be effective and safe for IHs in pediatric age group. Intervention in the early proliferative phase, with especially, the cephalic lesions result in better resolution rates with shorter duration of overall treatment.

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Section: Discussionsupporting

confidence: 90%

Oral propranolol in infantile hemangiomas: Analysis of factors that affect the outcome

Ainipully

Narayanan

Vazhiyodan

et al. 2019

J Indian Assoc Pediatr Surg

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“…Two large prospective studies reporting safe and effective outpatient treatment of IHs with propranolol in urban environments include 697 cases in Shanghai, China,14 and 188 cases in Melbourne, Australia 15. Thirty-one patients with IHs in the large city of Tijuana, Mexico, received propranolol treatment exclusively as outpatients with follow-up provided by physicians and pharmacists 16. The scant literature about initiating propranolol in a resource-limited outpatient setting includes a case report in a resource-poor area of Indonesia 20…”

Section: Discussionmentioning

confidence: 99%

Use of propranolol in a remote region of rural Guatemala to treat a large facial infantile haemangioma

et al. 2017

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We present a female infant with a right-sided facial and neck haemangioma, from a remote, resource-poor community in rural Guatemala. She received first-line treatment, propranolol, with marked reduction in tumour size and erythema. Treatment was stopped after 35 weeks due to recurrent diarrhoea and sustained weight loss. Propranolol can be used to safely treat infants with haemangiomas in remote, rural communities if there is adequate follow-up, education and communication. Periocular haemangiomas should be treated promptly to avoid visual impairment. Infants with large facial haemangiomas should be screened for osterior fossa anomalies,emangioma, rterial anomalies,ardiac anomalies, and ye anomalies (PHACE) syndrome, and specialists should be involved. The case also highlights the difficulty of providing treatment for a complex illness when basic health needs, such as food security and water sanitation, are limited.

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“…Until 2008, therapy for patients with IH was limited to corticosteroids as first-line treatment and procedures like surgery and laser treatment [ 2 ]. After the discovery by Léauté-Labrèze, numerous studies have been conducted to evaluate the efficacy and safety of propranolol, becoming the treatment of choice in patients with IH [ 5 , 11 , 13 , 14 ]. One disadvantage of this treatment is the lack of propranolol formulations adapted and available to the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…Recently the death of a pediatric patient with IH treated with propranolol was reported in Canada [ 8 ]. For this reason it is important that physician consider following strict patient screening guidelines and to carefully assess the probabilities of harm and benefit before prescribing propranolol, and the pharmacist provide to the parents information and education about the correct use of propranolol during therapy, in order to obtain a better treatment for the patient [ 8 , 11 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

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The Role of the Pharmacist in the Treatment of Patients with Infantile Hemangioma Using Propranolol

Castaneda¹,

Meléndez-López

Garcia³

et al. 2016

Adv Ther

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IntroductionInfantile hemangiomas (IH) are the most common benign vascular tumors of childhood, with an incidence of 5–10% during the first year of age. Propranolol is considered the first-line treatment for this condition. Potentially there is a high probability of negative results to therapy, because in many countries there are no treatment protocols or propranolol formulations appropriate for the pediatric population. The objective of the present study was to evaluate the impact of pharmacist interventions such as detecting, analyzing, and solving problems presented during treatment with propranolol in patients with IH.MethodsAn open observational prospective study was performed over 25 months in a group of pediatric patients diagnosed with infantile hemangioma treated with propranolol. Pharmacist participation consisted of development of an extemporaneous formulation and counseling the child’s parents. At each visit to the pharmacy service, family members were interviewed, detecting and classifying problems related to treatment.ResultsSixty-three children with IH were treated during the period under review. Patient ages ranged from 3 to 11 months old; 64% were female and 36% were male. Forty-nine problems in 30 patients were detected, principally inadequate dose (18.4%), non-adherence to treatment (16.3%), side effects (14.3%), and wrong administration (14.3%). Of the problems detected, 81.6% were resolved. Interventions by the pharmacist in 27 patients were intensive counseling on adherence to therapy (20%), detection of adverse effects (11.4%), and adjustment of the dose (22.9%). In 95.2% of patients a good response to treatment was obtained compared with 77.2% reported in European studies without pharmacist intervention.ConclusionIt seems that pharmacist participation increases adherence to treatment and reduces the likelihood of adverse effects, allowing for safe and effective therapy in patients with IH.

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Therapeutic Effect of Propranolol in Mexican Patients with Infantile Hemangioma

Cited by 12 publications

References 20 publications

Oral propranolol in infantile hemangiomas: Analysis of factors that affect the outcome

Oral propranolol in infantile hemangiomas: Analysis of factors that affect the outcome

Use of propranolol in a remote region of rural Guatemala to treat a large facial infantile haemangioma

The Role of the Pharmacist in the Treatment of Patients with Infantile Hemangioma Using Propranolol

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