title: Propranolol vs corticosteroids for infantile hemangiomas: a multicenter retrospective analysis.
abstract: OBJECTIVE
  To determine whether propranolol therapy is safe and effective and superior to oral corticosteroids for treating infantile hemangiomas (IHs).
  
  
  METHODS
  Multicenter retrospective chart review.
  
  
  METHODS
  University of Miami and Miami Children's Hospital, Miami, Florida. Patients  The study included 110 patients with IHs.
  
  
  METHODS
  The percentage of clearance was quantified by documented serial global photography and clinical examinations (length, height, and width) to segregate patients into 2 groups: patients who had clearance of 75% or more and patients who had less than 75% clearance.
  
  
  RESULTS
  The mean duration of treatment was 7.9 months for propranolol and 5.2 months for oral corticosteroids. Fifty-six of 68 patients (82%) who were receiving propranolol achieved clearance of 75% or more compared with 12 of 42 patients (29%) who were receiving oral corticosteroids (P < .01). Adverse effects were minimal in the propranolol group: 1 patient had hypoglycemia and 2 patients had a nonspecifice skin eruption that was not associated with propranolol therapy. All 42 patients in the corticosteroid group had 1 or more adverse effects (P < .01). Relapse after discontinuation of propranolol therapy occurred in 2 of the 68 patients; however, both patients responded to propranolol therapy on reinitiation of treatment. Surgical referrals after treatment were required in 8 patients (12%) in the propranolol group and 12 patients (29%) in the oral corticosteroid group (P < .01).
  
  
  CONCLUSIONS
  Propranolol therapy was more clinically effective and more cost-effective than oral corticosteroids in treating IHs. It also resulted in fewer surgical interventions and demonstrated better tolerance, with minimal adverse effects, compared with oral corticosteroids. Therefore, propranolol should be considered a first-line agent given its safety and efficacy in the treatment of IHs.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, Division of Pediatric Dermatology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Price
authors.forename: Carol
authors.initials: C
authors.lastname: Lattouf
authors.forename: Bertha
authors.initials: B
authors.lastname: Baum
authors.forename: Michael
authors.initials: M
authors.lastname: McLeod
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Schachner
authors.forename: Ana M
authors.initials: AM
authors.lastname: Duarte
authors.forename: Elizabeth Alvarez
authors.initials: EA
authors.lastname: Connelly
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D005938:Glucocorticoids; D011433:Propranolol