TY - JOUR T1 - Safety and effectiveness of oral propranolol for infantile hemangiomas started before 5 weeks and after 5 months of age: an Italian multicenter experience. JF - Ital J Pediatr Y1 - 2017 A1 - El Hachem, Maya A1 - Gesualdo, Francesco A1 - Diociaiuti, Andrea A1 - Berti, Irene A1 - Vercellino, Nadia A1 - Boccaletti, Valeria A1 - Neri, Iria A1 - Porcedda, Giulio A1 - Greco, Antonella A1 - Carnevale, Claudia A1 - Oranges, Teresa A1 - Cutrone, Mario A1 - Dalmonte, Pietro KW - Administration, Oral KW - Age Factors KW - Cohort Studies KW - Dose-Response Relationship, Drug KW - Drug Administration Schedule KW - Female KW - Hemangioma KW - Humans KW - Infant KW - Infant, Newborn KW - Italy KW - Male KW - Patient Safety KW - Propranolol KW - Retrospective Studies KW - Skin Neoplasms KW - Treatment Outcome AB -

BACKGROUND: Despite not being licensed for the treatment of infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for IH started before 5 weeks or after 5 months of age.

METHODS: We retrospectively reviewed the records of patients followed up for IH, on propranolol treatment started before 5 weeks or after 5 months of age, and collected information on sociodemographic data, treatment indications, IH involution, IH relapse, and treatment side effects.

RESULTS: A total of 343 patients were enrolled; 15 were started on propranolol before 5 weeks (group 1), 328 were started after 5 months of age (group 2). The most frequent indications were permanent aesthetical disfigurement (91.8%) and function threatening complications (42.6%). In most cases, the treatment was effective. The involution was partial in 67.7% of patients. In 11.8% of cases a relapse was observed. No relapse was observed in group 1. Treatment complications were reported in 15.8% of children, most frequently sleep disorders (6.6%), followed by irritability (5.1%) and diarrhea (2.2%). Only a case of mild constipation was observed in group 1.

CONCLUSION: The safety and effectiveness profile of propranolol in infants younger than 5 weeks or older than 5 months may be acceptable. Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the <5-week age group .

VL - 43 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28424095?dopt=Abstract ER -