Oral propranolol is widely prescribed as first line treatment for infantile haemangiomas (IHs) and anecdotally prescribing practice differs widely between centres

Audrain, H

Baryschpolec, S

Baselga Torres, E

Beattie, P E

Bhate, K

Bjerre, J V

Brown, S J

Burrows, N P

Clayton, T H

Darne, S

Durack, A

Dvorakova, V

Flohr, C

Foelster-Holst, R

Gach, J

Glover, M

Goldstraw, N

Goodyear, H

Grabcyznska, S

Greenblatt, D

Halpern, J

Hearn, R M R

Hedelund, L

Hernandez-Martin, A

Hoeger, P H

Hoey, S

Hughes, B

Irvine, A D

Janmohamed, S R

Jayaraj, R

Johansson, E K

Laguda, B

Lam, M

Leech, S

Lund University.

McPherson, T

Morrison, D

Neri, I

O'Regan, G M

Oranje, A

Patrizi, A

Porter, W

Ramesh, R

Ravenscroft, J

Schill, T

Shahidullah, H

Shaw, L

Soloman, L

Svensson, Åke,

Taylor, A E M

Taylor, R

Thomson, J

Tiffin, P

Tsakok, M

Wahlgren, C F

Wedgeworth, E

BACKGROUND



Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres.



OBJECTIVES



The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.



METHODS



Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool.



RESULTS



The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of  2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend < 0·001.



CONCLUSIONS



The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study

Baselga, E

Grabczynska, S

Oranje, A P

Ravenscroft, J C

Solman, L

Svensson, A

HEFT Repository

Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey.

Heart of England: HEFT Repository

Summary
               
                  Background
                  Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres.
               
               
                  Objectives
                  The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.
               
               
                  Methods
                  Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool.
               
               
                  Results
                  The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg−1 per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of &amp;lt; 2 mg kg−1 vs. 2 mg kg−1 vs. &amp;gt; 2 mg kg−1, the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33–1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04–5·46, P = 0·04, Ptrend &amp;lt; 0·001.
               
               
                  Conclusions
                  The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.
               </jats:sec

E. Wedgeworth

M. Glover

A.D. Irvine

I. Neri

E. Baselga

T.H. Clayton

P.E. Beattie

J.V. Bjerre

N.P. Burrows

R. Foelster-Holst

L. Hedelund

A. Hernandez-Martin

H. Audrain

K. Bhate

S.J. Brown

S. Baryschpolec

S. Darne

A. Durack

V. Dvorakova

J. Gach

N. Goldstraw

H. Goodyear

S. Grabczynska

D. Greenblatt

J. Halpern

R.M.R. Hearn

S. Hoey

B. Hughes

R. Jayaraj

E.K. Johansson

M. Lam

S. Leech

G.M. O'Regan

D. Morrison

W. Porter

R. Ramesh

T. Schill

L. Shaw

A.E.M. Taylor

R. Taylor

J. Thomson

P. Tiffin

M. Tsakok

S.R. Janmohamed

B. Laguda

T. McPherson

A.P. Oranje

A. Patrizi

J.C. Ravenscroft

H. Shahidullah

L. Solman

A. Svensson

C.F. Wahlgren

P.H. Hoeger

C. Flohr

Crossref

British Journal of Dermatology

Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey

BACKGROUND: Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres.OBJECTIVES: The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.METHODS: Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool.RESULTS: The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of &lt; 2 mg kg(-1) vs. 2 mg kg(-1) vs. &gt; 2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend &lt; 0·001.CONCLUSIONS: The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.</p

Discovery Research Portal

Propranolol in the treatment of infantile haemangiomas:lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey

Swepub

Propranolol in the treatment of infantile haemangiomas: Lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce Survey

English

Background Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres. Objectives The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs. Methods Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool. Results The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg-1 per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of &lt; 2 mg kg-1 vs. 2 mg kg-1 vs. &gt; 2 mg kg-1, the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend &lt; 0·001. Conclusions The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.</p

Wedgeworth, E.

Glover, M.

Irvine, A. D.

Neri, I.

Baselga, E.

Clayton, T. H.

Beattie, P. E.

Bjerre, J. V.

Burrows, N. P.

Foelster-Holst, R.

Hedelund, L.

Hernandez-Martin, A.

Audrain, H.

Bhate, K.

Brown, S. J.

Baryschpolec, S.

Darne, S.

Durack, A.

Dvorakova, V.

Gach, J.

Goldstraw, N.

Goodyear, H.

Grabczynska, S.

Greenblatt, D.

Halpern, J.

Hearn, R. M.R.

Hoey, S.

Hughes, B.

Jayaraj, R.

Johansson, E. K.

Lam, M.

Leech, S.

O'Regan, G. M.

Morrison, D.

Porter, W.

Ramesh, R.

Schill, T.

Shaw, L.

Taylor, A. E.M.

Taylor, R.

Thomson, J.

Tiffin, P.

Tsakok, M.

Janmohamed, S. R.

Laguda, B.

McPherson, T.

Oranje, A. P.

Patrizi, A.

Ravenscroft, J. C.

Flohr, Carsten

King's Research Portal

Propranolol in the treatment of infantile haemangiomas:Lessons from the European Propranolol in the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey

Abstract
BACKGROUND:

Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres.
OBJECTIVES:

The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.
METHODS:

Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool.
RESULTS:

The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of &lt; 2 mg kg(-1) vs. 2 mg kg(-1) vs. &gt; 2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend &lt; 0·001.
CONCLUSIONS:

The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study

NERI, IRIA

Foelster Holst, R.

Hernandez Martin, A.

Hearn, R. M. R.

Taylor, A. E. M.

Mcpherson, T.

PATRIZI, ANNALISA

Shahidullah, H.

Solman, L.

Svensson, A.

Wahlgren, C. F.

Hoeger, P. H.

Flohr, C.

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Propranolol in the treatment of infantile haemangiomas: Lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey

https://discovery.dundee.ac.uk/files/11703904/PITCH_survey_BJD_FINAL_FINAL_after_reviewer_comments_UNTRACKED.pdf

Propranolol in the treatment of infantile haemangiomas:lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey

Abstract

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HEFT Repository

Heart of England: HEFT Repository

Crossref

Discovery Research Portal

Swepub

Discovery Research Portal

Discovery Research Portal

King's Research Portal

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

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