Propranolol for treatment of infantile hemangioma: a systematic evaluation

Abstract

Objective To systematically review the literature evaluating efficacy and adverse events of propranolol for infantile hemangiomas (IHs). Methods We searched the Cochrane, Medline, Wiley, CNKI and Wanfang Databases for all studies on the response of IHs to propranolol only which were published between June 2008 and May 2013. Results A total of 23 studies were collected, including 14 case reports and 2 follow-up studies which were without random and control; another 6 studies were clinical controlled trials and 1 study was RCT. Total 716 patients were included, and never received other treatments before propranolol. Propranolol was initiated at a mean age of (4.5±0.5) months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of (9.7±9.2) months. The effective rate for patients with IHs treated with propranolol was 97% (691/716), and patients after treatment completion reported IHs recurred in 8.6% of patients. The adverse effects rate was 31% (223/7167) which most common adverse events were changes in sleep (n=35), gastrointestinal reaction (n=52) and decreased heart rate (n=73), and 5 patients discontinued the treatment because of the serious adverse events. Conclusions This systematic review of 716 patients treated with propranolol for IHs show a high rate of efficacy and a low rate of serious adverse events, and it is a better treatment of infantile hemangioma, but we should pay more attention to the serious adverse events and strictly select indications. Key words: Hemangiomas; Propranolol; Infantile