title: A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma.
abstract: OBJECTIVE
  To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response.
  
  
  METHODS
  Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH.
  
  
  RESULTS
  Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events.
  
  
  CONCLUSIONS
  Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Yeong Ju
authors.initials: YJ
authors.lastname: Yun
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Yun Hee
authors.initials: YH
authors.lastname: Gyon
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Sohyoung
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Youn Kyung
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Joohyun
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Meerim
authors.initials: M
authors.lastname: Park
keywords: Effect; Hemangioma; Propranolol; Safety