title: The role of propranolol in the treatment of infantile hemangioma.
abstract: BACKGROUND
  Infantile hemangioma (IH) is one of the most common childhood tumors. There are various medical or surgical therapeutic options, all with suboptimal results. Recently, the successful use of propranolol for involution of IH was described. We report the results of a single-center experience with this therapeutic option.
  
  
  OBJECTIVE
  To prospectively assess the efficacy and safety of propranolol in children with infantile hemangioma.
  
  
  METHODS
  We performed a prospective analysis of clinical data of all patients with IH referred to a pediatric cardiology center for baseline cardiovascular assessment prior to propranolol therapy. Propranolol was given at a starting dose of 1 mg/kg/day and titrated to a target dose of 2-3 mg/kg/day according to clinical response. Efficacy was assessed through a photograph-based severity scoring scale. Safety was assessed by collecting data regarding significant side effects.
  
  
  RESULTS
  Starting in 2010, 30 patients (15 female) were referred for propranolol treatment of IH, at a median age of six months (1-63 months). The mean target propranolol dose was 2.8 mg/kg/day, with a mean duration of therapy of 12 months. All patients experienced significant reduction of IH size and volume. There were no side effects.
  
  
  CONCLUSIONS
  In our experience propranolol appears to be a useful and safe treatment option for severe or complicated IH, achieving a rapid and significant reduction in their size. No adverse effects were observed, although until larger clinical trials are completed, potential adverse events should be borne in mind and consultation with local specialists is recommended prior to initiating treatment.
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal. Electronic address: sergiolaranjo@gmail.com.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Laranjo
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Glória
authors.initials: G
authors.lastname: Costa
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Paramés
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Freitas
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: José Diogo
authors.initials: JD
authors.lastname: Martins
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Conceição
authors.initials: C
authors.lastname: Trigo
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Fátima F
authors.initials: FF
authors.lastname: Pinto
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D011433:Propranolol
keywords: Hemangioma infantil; Infantile hemangioma; Propranolol