Retrospective analysis of beta-blocker instituted for treatment of hemangiomas (RABBIT study).
OBJECTIVE
To evaluate the safety and efficacy of our institutional beta-blocker protocol for treatment of complicated infantile hemangiomas (IH).


METHODS
A retrospective descriptive study of 76 infants/children with IH treated with oral propranolol at the Children's Hospital of Philadelphia between June 2008 and August 2010 was performed, assessing both the safety and efficacy of propranolol. Based on preliminary data showing hemangioma recrudescence off-treatment, we reviewed 9 additional patients with recrudescence between August 2010 and December 2011.


RESULTS
Mild adverse events included asymptomatic bradycardia, gastrointestinal symptoms, asymptomatic hypotension, cool hands/feet, asymptomatic hypoglycemia, and sleep disturbance. Sixteen patients had recrudescence of IH off-treatment, with propranolol discontinued at a median age of 14 months (interquartile range 10-15 months).


CONCLUSIONS
Propranolol appears to be associated with minor, not severe symptomatic adverse events. Propranolol appears to be effective in treating complicated IH. Recrudescence can occur off-treatment, even with discontinuing propranolol as late as 15 months of age.
Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA derek.chu@uphs.upenn.edu.
Derek H
DH
Chu
Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Leslie
L
Castelo-Soccio
Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Joy
J
Wan
Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Joel M
JM
Gelfand
Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Robert E
RE
Shaddy
Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Kara N
KN
Shah
Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Marissa J
MJ
Perman
Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
James R
JR
Treat
Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Albert C
AC
Yan
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015143:Philadelphia; D011433:Propranolol / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D011433:Propranolol
adverse effects; bradycardia; hypoglycemia; hypotension; infantile hemangioma; propranolol; recrudescence