Propranolol therapy in infantile hemangioma: correlation of age and duration of treatment to the outcomes

Background
Infantile hemangioma (IH) is the commonest vascular tumor affecting children that appears in the first 2 weeks of life and follows a proliferative phase that continues during the first year of life. After then, it undergoes involution, which lasts for several months or years depending on the size, site, gender, and development of complications. The purpose of this prospective study was to evaluate the correlation of age and duration of propranolol therapy to the outcomes of infantile hemangioma.
Methods
A prospective study included 28 patients with IH in which the propranolol therapy was initiated in a dose of 3 mg/kg/day divided into two to three doses. The surface area of IH was calculated monthly using AutoCAD software. Treatment with propranolol was discontinued when there was no more decrease in the surface area for two consecutive visits. Eleven males and 17 females completed the study. The age at initiation of therapy ranged from 2 to 16 months while at the end of therapy it was 9 to 23 months.
Results
The mean difference percent of surface area at 6 months was (51.1 ± 16.3), while at the end of the treatment course was (75.0±16.8) which was statistically significant ( < 0.0001). In addition, a significant inverse correlation was found between the age at the beginning of treatment and the difference percent of surface area. A similar inverse correlation was observed between the age at the beginning of treatment and the duration of treatment.
Conclusion
In addition to the safety and efficacy of propranolol therapy for IH, a higher response rate can be gained with early treatment and a prolonged course of therapy. In addition, propranolol therapy should be continued until there is no more response for two consecutive months regardless of the age of therapy initiation and the duration of treatment.