Propranolol in the Treatment of Infantile Hemangioma: Clinical Effectiveness, Risks, and Recommendations

The document from 2011 reviews the use of propranolol, a beta-blocker, for treating infantile hemangioma, detailing its effectiveness and safety. Propranolol is now often used as a first-line treatment due to its favorable safety profile and effectiveness, typically prescribed at a dosage of 2 mg/kg/day. Side effects can occur, including hypoglycemia, hypotension, and bronchospasm, but are generally mild. Studies mentioned include one with 30 infants showing variable responses based on ulcer size, and another with 33 infants where the mean time to cure ulcers was 4.3 weeks. In a series of 17 patients, 82% experienced tumor shrinkage within a month, and another series showed all 14 patients with airway hemangiomas had clinical improvement. The use of propranolol in PHACE syndrome is controversial, and while beta-blockers are not officially approved for treating hemangiomas, they are considered safe with diligent follow-up. The document concludes that beta-blockers may become the preferred treatment, but more research is needed to determine the best practices for dosing, monitoring, and specific beta-blocker selection.