Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey.
نویسندگان
چکیده
BACKGROUND Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres. OBJECTIVES The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs. METHODS Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool. RESULTS The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of < 2 mg kg(-1) vs. 2 mg kg(-1) vs. > 2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend < 0·001. CONCLUSIONS The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.
منابع مشابه
Propranolol for infantile haemangiomas: single centre experience of 250 cases and proposed therapeutic protocol.
OBJECTIVE To assess the safety and efficacy of systemic propranolol for the treatment of complicated infantile haemangiomas. DESIGN Retrospective review of case notes of paediatric patients treated with propranolol for complicated infantile haemangiomas. SETTING Tertiary care children's hospital. PATIENTS All paediatric patients with complicated infantile haemangiomas who commenced treatm...
متن کاملPropranolol therapy for infantile haemangiomas: review of the literature.
OBJECTIVES Haemangiomas are the most common tumors of infancy affecting approximately 1 in 10 children. Unlike other tumors, haemangiomas enter an involution phase, during which they usually regress over the next several months to years. Sometimes intervention is required due to proliferative growth which is complicated by ulceration, bleeding, persistent aesthetic deformity or infection. MET...
متن کاملUse of propranolol in infantile haemangiomas: report of five cases and review of the literature.
Infantile haemangiomas are common benign tumours that do not require treatment unless they cause significant functional impairment or disfigurement. We report our experience with the off-label use of propranolol in 5 children with haemangiomas and review the relevant literature.
متن کاملPropranolol for infantile haemangiomas: a review.
Infantile haemangiomas are the most common benign tumour of infancy. However the majority are self-resolving and only a small minority of cases require treatment, with various different medications being used in the past. Over the last few years, propranolol, a non-selective β-blocker, has become a popular and successful treatment for infantile haemangiomas. However, further research on its saf...
متن کاملA revolution in the management of infantile haemangiomas.
In a letter to the editor, Léauté-Labrèze and colleagues describe the chance observation of the significant beneficial effects of propranolol on infantile haemangiomas (IH). A child, aged four months, had a large nasal IH, which had not responded to standard treatment with oral prednisolone (3 mg/kg/day). Coincidentally, the infant developed hypertrophic obstructive cardiomyopathy and was comme...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The British journal of dermatology
دوره 174 3 شماره
صفحات -
تاریخ انتشار 2016