title: Propranolol therapy of infantile hemangiomas: efficacy, adverse effects, and recurrence.
abstract: OBJECTIVE
  To evaluate the efficacy, adverse effects, and recurrence of oral propranolol for treatment of infantile hemangioma.
  
  
  METHODS
  Participants were treated with oral propranolol three times daily, with inpatient monitoring of adverse effects. The starting dosage was 2 mg/kg per day, which had been for the remaining duration of treatment. Therapy duration was planned for 4-6 months; if there was significant relapse, the period of treatment was extended. A photograph based severity scoring assessment was performed by three observers to evaluate efficacy by visual analog scale (VAS).
  
  
  RESULTS
  Sixty-one infants [median age 3.3 (1.2-8.1) months] were included in the study. The median follow-up-time was 15 (6-20) months and 53 patients completed treatment at a median age of 10.3 (8.4-18.1) months, after a duration of 8.5 (4.5-14) months. In all patients, there was significant fading of color [with a VAS of -9 (-6 to -9) after 6 months] and significant decrease in size of the infantile hemangiomas [with a VAS of -8 (-3 to -10) after 6 months]. We did not observe any life-threatening adverse effects. The therapy was interrupted due to temporary aggravation of pre-existing bronchial asthma in one child. Four cases presented partial recurrences.
  
  
  CONCLUSIONS
  Oral propranolol 2 mg/kg per day was a well-tolerated and effective treatment, mild adverse effects, and low recurrence for infantile hemangiomas. Propranolol should now be used as a first-line treatment in hemangiomas when intervention is required. Also, prospective studies should be needed in determining the most effective treatment dosage, optimum treatment duration, and exact mechanism of action of propranolol in future.
authors.affiliation: Department of Plastic Surgery, General Hospital of Guangzhou Military Command (Liuhuaqiao Hospital), 111 Liu Hua Road, Yue Xiu District, 510010 Guangzhou, People's Republic of China. hnxiaoq@sina.com.cn
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xiao
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Wenlin
authors.initials: W
authors.lastname: Yu
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011433:Propranolol / Q000008:administration & dosage*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol