title: Treatment for Infantile Hemangiomas: Selection Criteria, Safety, and Outcomes Using Oral Propranolol During the Early Phase of Propranolol Use for Hemangiomas.
abstract: OBJECTIVE
  Despite the increasing popularity of propranolol for treatment of infantile hemangioma (IH), there is need for further evidence of efficacy and safety. This study is a retrospective review of one institution's experience treating IH with propranolol using a standard protocol.
  
  
  METHODS
  Between 2009 and 2014, patients with IH were evaluated for treatment with propranolol. Exclusion criteria included a history of hypoglycemia, respiratory disorders, and cardiovascular disorders. Propranolol, 2 mg/kg/d, was initiated during 48-hour inpatient stay. Weight and complications were monitored. Appearance was assessed by Visual Analog Cosmetic Scale (VACS) via serial photography.
  
  
  RESULTS
  Twenty-three patients were treated with propranolol. Average age at initiation of therapy was 14.9 weeks. Twenty-two lesions were on the head and neck, and 1 was on the trunk. Average treatment duration was 54.3 weeks (range 24-148 wk). Treatment was confirmed to be complete in 23 patients at the time of review (91.3%). Two patients were lost to follow-up. Posttreatment color, size, and VACS improved significantly (P < 0.05). There was no significant difference between first and most recent weight. Two patients experienced hypoglycemia, 1 during a diarrheal illness and 1 during inpatient treatment initiation.
  
  
  CONCLUSIONS
  The authors present a series of patients with IH safely treated with 2 mg/kg/d of propranolol. Using a strict protocol, few complications were observed. Patients achieved significant reduction in size and improvement of the overall appearance of IH.
authors.affiliation: *University of Pittsburgh Medical Center, Pittsburgh, PA †University of Wisconsin, Madison, WI.
authors.forename: Zoe M
authors.initials: ZM
authors.lastname: MacIsaac
authors.forename: Harry S
authors.initials: HS
authors.lastname: Nayar
authors.forename: Robin
authors.initials: R
authors.lastname: Gehris
authors.forename: Deepak
authors.initials: D
authors.lastname: Mehta
authors.forename: Susan
authors.initials: S
authors.lastname: Geisler
authors.forename: Lorelei J
authors.initials: LJ
authors.lastname: Grunwaldt
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001835:Body Weight; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D008297:Male; D018579:Patient Selection; D011433:Propranolol / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D064232:Visual Analog Scale
chemical_list: D000319:Adrenergic beta-Antagonists; D000970:Antineoplastic Agents; D011433:Propranolol