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KMID : 0869620140310020705
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 2 p.705 ~ p.712
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Drug Use Evaluation of Low-dose Propranolol on Infantile Hemangioma
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Son Rin
Jung Ae-Hee
Cho Eun-Jeong
Lee Yong-Hwa
Lee Hye-Sook
Kim Hyang-Suk
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Abstract
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Infantile hemangiomas (IH) are the most common benign tumor during childhood. The majority are self-resolving, however, 10% of patients require treatment. Researches on the efficacy of propranolol for IH have been reported outside of Korea since 2008. This study evaluated a low-dose propranolol use on IH based on its clinical efficacy and adverse event profiles. Total of 59 children, 3-year-old or younger, diagnosed IH and took propranolol as a maintenance dosage of 2 mg/kg/day between November 2009 and July 2011, were culled from Seoul National University Children’s Hospital using electrolyte medical records retrospectively. For comparison, clinical photos were taken before, during and after treatment.
IH was predominantly presented in female (Male: Female=1:2.5), 39% of which occurred and was distinguished at birth (n=23). For the remains (n=36), 69% of children (n=25) occurred within a month. Location of the IH was as follows: face and neck (n=44), trunk (n=4), the limbs (n=6), multiples (n=5), respectively. Mean age of treatment initiation was 5-month-old (range 1.3-16) and the total duration of treatment was an average of 8 months (range 2.3-22). 22% of patients showed a rebound growth when the medication was discontinued and restarted propranolol, receiving relatively shorter courses; a mean of 4 months (range 1 week - 11 months). Based on the initial diagnosis, more than 50% of the reduction in the size of lesion was exhibited at 48 patients, followed by four with less reduction and no changes in seven. Total 59% of patients
(n=36) displayed improvement within a month such as a regression in size, softening in the lesion and faded in color. 22 patients experienced minor but reportable side effects to propranolol, including rash (n=8), gastro-esophageal reflux (n=7), hypotension (n=3), somnolence (n=2), and others (respiratory distress, n=1, hypothermia, n=1), respectively. In this study, the clinical efficacy of low-dose propranolol use on IH was confirmed. Due to the limited data from Seoul National University Children’s Hospital, prospective studies with more patients are needed and the guideline for duration and dosage of propranolol should be further elaborated.
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KEYWORD
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Infantile hemangioma, Propranolol, Efficacy
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