Propranolol treatment for severe infantile hemangiomas: A single-centre 3-year experience

Aim: To evaluate the effectiveness, safety and tolerability of propranolol as single-agent treatment in patients with problematic, proliferative-phase, infantile hemangiomas (IHs). Methods: Oral propranolol was administered at a dose of 2 mg/kg/day to 28 children. Cardiologic evaluation was performed before treatment initiation. Hemodynamic variables and blood glucose levels were monitored during the first 24 h of treatment, while the children were hospitalized. Clinical response and tolerance were assessed every month, along with photographic documentation. Macroscopic regression was considered the reduction >90% in the size of the IHs. Results: Effects on colour and growth were observed within the first month in all cases. Twenty-four patients completed treatment after a mean duration of 7.56 months, and their hemangiomas were successfully regressed. Propranolol was administered again, with satisfactory results, in three patients (12.5%) because of hemangioma regrowth. Satisfactory response is noticeable in ongoing cases. Episodes of hypotension were noted in four patients. There were no treatment interruptions because of side effects. Conclusions: Propranolol, as first-line treatment, yielded excellent results with very good clinical tolerance and also seems to be effective in relapses. The optimal duration of the treatment remains to be defined by long-term observation. © 2012 Foundation Acta Pædiatrica