Safety and Effectiveness of Oral Propranolol for Infantile Hemangiomas Started Before 5 weeks and After 5 months of Age: an Italian Multicenter Experience

Overview

Journal Ital J Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2017 Apr 21

PMID 28424095

Citations 4

Authors

Maya El Hachem

Francesco Gesualdo

Andrea Diociaiuti

Irene Berti

Nadia Vercellino

Valeria Boccaletti

Iria Neri

Giulio Porcedda

Antonella Greco

Claudia Carnevale

Teresa Oranges

Mario Cutrone

Pietro Dalmonte

Affiliations

Soon will be listed here.

Abstract

Background: Despite not being licensed for the treatment of infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for IH started before 5 weeks or after 5 months of age.

Methods: We retrospectively reviewed the records of patients followed up for IH, on propranolol treatment started before 5 weeks or after 5 months of age, and collected information on sociodemographic data, treatment indications, IH involution, IH relapse, and treatment side effects.

Results: A total of 343 patients were enrolled; 15 were started on propranolol before 5 weeks (group 1), 328 were started after 5 months of age (group 2). The most frequent indications were permanent aesthetical disfigurement (91.8%) and function threatening complications (42.6%). In most cases, the treatment was effective. The involution was partial in 67.7% of patients. In 11.8% of cases a relapse was observed. No relapse was observed in group 1. Treatment complications were reported in 15.8% of children, most frequently sleep disorders (6.6%), followed by irritability (5.1%) and diarrhea (2.2%). Only a case of mild constipation was observed in group 1.

Conclusion: The safety and effectiveness profile of propranolol in infants younger than 5 weeks or older than 5 months may be acceptable. Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the <5-week age group .

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