HM Cakmak, O Kartal

Abstract

Purpose: Propranolol is the mainstay treatment of infantile haemangioma, and the optimal dose is unclear. The propranolol treatment protocol has not been standardised. This study aims to compare the efficacy of medium-dose propranolol (2 mg/kg/day) and high-dose propranolol (3 mg/kg/day). Methods: In this retrospective non-randomised series study (n=108) (15 days, 27 months of age), we designed three groups, no treatment (n=33), propranolol 2 mg/kg/day (n=39) and propranolol 3 mg/kg/day (n=36). The patients with high-risk features and a score of >6 points received propranolol with a random final dose of 2 or 3 mg/kg/day for 6 or 12 months. The patients were followed for up to twelve months, and their resolution rates were calculated using ultrasonographic volume changes. Findings: The demographics and clinical features of the groups (no-treatment, propranolol 2 mg/kg/day, propranolol 3 mg/kg/day) were similar. Propranolol (2 mg/kg/day and 3 mg/kg/day) treatment achieved significantly more resolution than no treatment group (p<0.001). Comparing propranolol 2 mg/kg/day and 3 mg/kg/day groups, we found the resolution rates similar (68.59 ± 28.95 vs 73.44 ± 32.54)(p=0.673) and twelfth months (89.08 ± 46.58 vs 91.13 ± 37.46 respectively) (p=0.673) of follow up. Mild (n=3) (4%) adverse events were managed with no cessation. We stopped the treatment in one patient with an atrioventricular block. Conclusions: Propranolol is a safe drug for treating infantile haemangioma. The treatment regimen with a propranolol dose of 3 mg/kg per day has the same resolution rate as the 2 mg/kg regimen. Therefore, 2 mg/kg/day is a good option for infantile haemangioma.