Therapeutic efficacy of propranolol for infantile hemangiomas

Objectives. This was a retrospective study to analyze the clinical therapeutic efficacy of propranolol in patients with infantile hemangioma (IH). Study Design. Patients with IH were treated with propranolol (2-4.5 mg/kg/day). Those patients who did not have a good response to propranolol underwent intertumoral injection of pingyangmycin or surgery. Results. Relative therapeutic responses to propranolol among the 51 patients were as follows: excellent in 31.37% (16 of 51); good in 39.21% (20 of 51); poor in 23.53% (12 of 51); and nonresponsive in 3.92% (3 of 51). Of the 15 patients who had a poor or no response to propranolol, 2 received injected pingyangmycin, and 3 underwent surgical resection; the remaining 10 patients received no further therapy. The relevance of many clinical factors (sex, age, dose, depth, and diameter) to the efficacy of propranolol was assessed with univariate and multivariate ordinal logistic regression models, which indicated that young age (<= 5 months) was significantly associated with better efficacy (P < .05). The most common side effect was diarrhea (52.2%). There was no significant association between dose of propranolol and side effects (P = .12). Conclusions. The effect of oral propranolol was better in younger patients. A 3- to 4.5-mg/kg/day dose may not be more effective than the conventional recommended dose of 2 to 3 mg/kg/day.