OncoLink en espanõl
Share
Cancer Resources > Cancer News > 2009 > August
Propranolol useful for severe infantile hemangiomas
Last Updated: 2009-08-10 8:29:04 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Propranolol is a safe treatment for severe infantile hemangiomas that can markedly shorten the disease course, according to findings from a small study reported in the September issue of Pediatrics.
Within just a few hours of treatment, propranolol reduced the color and growth of hemangiomas, an effect that was most pronounced in patients with dyspnea, hemodynamic compromise, or palpebral occlusion, the report indicates.
Corticosteroids are the standard first-line treatment for infantile hemangiomas with interferon or vincristine being used in refractory cases, Dr. Alain Taieb, from Children's Hospital, Bordeaux, France, and colleagues note. However, due to side effects and limited efficacy, new therapies are needed.
"We observed serendipitously that propranolol, a well-tolerated, nonselective, beta-adrenergic receptor blocker commonly used for cardiologic indications in young children, can control the growth of infantile hemangiomas efficiently," the authors explain.
After witnessing the improvement in the index patient, the researchers used propranolol to treat 32 infants who were 4.2 months of age, on average, when treatment began. The drug was started at a dose of 2 to 3 mg/kg per day, which was administered in 2 or 3 divided doses.
Heart rate and blood pressure monitoring were performed during the first 6 hours of therapy. Barring side effects, therapy was continued at home with a follow-up visit at 10 days and then on a monthly basis. Ultrasound assessment was conducted at 60 days.
As noted, propranolol therapy produced rapid improvements. Within 2 months of treatment, complete ulcer healing was noted, a process that typically takes several months. Clinical and ultrasound evidence of longer-term regression was apparent at 2 months. Many of the children were able to discontinue corticosteroid therapy within a few weeks.
On average, propranolol therapy was given for 6.1 months. Although a few patients experienced disease relapses, they were mild in nature and resolved with retreatment. As noted, side effects were generally mild and treatment was well tolerated; however, one patient discontinued therapy due to wheezing.
"If these findings are confirmed in larger comparative studies, then propranolol could become the first-line treatment for infantile hemangiomas," the authors conclude.
Pediatrics 2009;124:e1-e9.
Copyright © 2010 Reuters Limited. All rights reserved.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.