Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas

Shanghai Journal of Stomatology ›› 2016, Vol. 25 ›› Issue (3): 257-260.

Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas

ZHENG Jia-wei¹, WANG Xu-kai², QIN Zhong-ping³, FAN Xin-dong⁴, LI Kai⁵, YANG Yao-wu⁶, HUO Ran⁷, LIU Shao-hua⁸, ZHAO Ji-hong⁹, WANG Xiao-yong¹⁰, ZHOU De-kai¹¹

1. Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
2. Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University;
Liaoning Institute of Dental Research. Shenyang 110001, Liaoning Province;
3. Special Department of Hemangioma, Tumor Hospital of Linyi City. Linyi 276001, Shandong Province;
4. Department of Intervention Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
5. Department of Pediatric Surgery, Children's Hospital of Fudan University. Shanghai 201102;
6.Department of Head and Neck Tumor Surgery, School of Stomatology, The Fourth Military Medical University. Xi'an 710032, Shaanxi Province;
7. Department of Aesthetic Plastic and Burn Surgery, Shandong Provincial Hospital, Shandong University. Jinan 250021,Shandong Province;
8. Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University. Jinan 250012,Shandong Province;
9.Department of Oral Surgery, School of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
10. Department of Infantile Hemangioma, Shanghai Cao'an Hospital. Shanghai 201804;
11. Department of Infantile Hemangioma, Gastrointestinal and Neonatal Surgery, Children's Hospital of Chongqing Medical University. Chongqing 400014, China

Received:2016-01-18 Revised:2016-03-20 Online:2016-06-25 Published:2016-07-22

Abstract

Abstract: Infantile hemangioma (IH) is one of the most common benign vascular tumors in children. A variety of treatment methods have been documented for the management of IH over the past years, including pharmacotherapy via oral administration or injection of corticosteroids, vincristine, alpha interferon and bleomycin; laser therapy, radionuclide therapy, cryotherapy and excisional surgery. The therapeutic efficacy of each treatment modality is variable, while adverse effects or complications are common and sometimes serious. Since the serendipitous discovery of propranolol, a nonselective beta-adrenergic receptor blocker, being very efficacious in treating IH in 2008, oral propranolol has earned a role as a first-line medical therapy for complicated IH. However, the appropriate drug dosage, dosing regimen, time for initiation, optimal duration, monitoring for side effects remains controversial. To standardize the use of propranolol in treating IH, avoid overtreatment or under-treatment, as well as minimize complications, a Chinese experts consensus on the use of oral propranolol for treatment of IH has been approved and written by a multidisciplinary experts group based on an up-to-date literature review and repeated discussion.

Key words: Propranolol, Infantile hemangioma, Experts consensus

CLC Number:

R739.8

ZHENG Jia-wei, WANG Xu-kai, QIN Zhong-ping, FAN Xin-dong, LI Kai, YANG Yao-wu, HUO Ran, LIU Shao-hua, ZHAO Ji-hong, WANG Xiao-yong, ZHOU De-kai. Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas[J]. Shanghai Journal of Stomatology, 2016, 25(3): 257-260.

References

[1] Kilcline C, Frieden IJ. Infantile hemangiomas: how common are they? A systematic review of the medical literature [J]. Pediatr Dermatol,2008,25(2):168-173.
[2] Chang LC, Haggstrom AN, Drolet BA, et al. Growth characteristics of infantile hemangiomas: implications for management [J].Pediatrics, 2008,122(2):360-367.
[3] Weiss I, Lipari BA, Meyer L, et al. Current treatment of parotid hemangiomas [J]. Laryngoscope, 2011,121(8):1642-1650.
[4] 郑家伟.婴幼儿血管瘤“等待观察”的治疗策略应予改变[J].中国口腔颌面外科杂志,2012,10(2):163-164.
[5] Liu X, Qu X, Zheng J, et al. Effectiveness and safety of oral propranolol versus other treatments for infantile hemangiomas: a meta-analysis[J]. PLoS One, 2015,10(9):e0138100.
[6] Léauté-Labréze C, Dumas de la Roque E, Hubiche T, et al. Propranolol for Severe Hemangiomas of Infancy [J]. N Engl J Med, 2008,358(24):2649-2651.
[7] Drolet BA, Frommelt PC, Chamlin SL, et al. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference [J]. Pediatrics, 2013,131(1):128-140.
[8] Hoeger PH, Harper JI, Baselga E, et al. Treatment of infantile haemangiomas: recommendations of a European expert group [J]. Eur J Pediatr, 2015,174(7):855-865.
[9] 秦中平,刘学键,李克雷,等.小剂量普萘洛尔口服治疗婴儿血管瘤的近期疗效与安全性评价[J].中华医学杂志,2009,89(44):3130-3134.
[10] Zhou HH, Koshakji RP, Silberstein DJ, et al. Altered sensitivity to and clearance of propranolol in men of Chinese descent as compared with American whites [J]. N Engl J Med, 1989,320(9):565-570.
[11] Tan ST, Itinteang T, Leadbitter P. Low dose propranolol for infantile haemangioma[J]. J Plast Reconstr Aesthet Surg, 2011,64(3): 292-299.
[12] Siegfried EC, Keenan WJ, Al-Jureidini S. More on propranolol for hemangiomas of infancy [J]. N Engl J Med, 2008,359(26):2846.
[13] Rangno RE, Nattel S, Lutterodt A. Prevention of propranolol withdrawal mechanism by prolonged small dose propranolol schedule[J]. Am J Cardiol, 1982,49(4):828-833.
[14] Love JN, Sikka N. Are 1-2 tablets dangerous? Beta-blocker exposure in toddlers [J]. J Emerg Med, 2004,26(3):309-314.
[15] Cushing SL, Boucek RJ, Manning SC, et al, Initial experience with a multidisciplinary strategy for initiation of propranolol therapy for infantile hemangiomas[J]. Otolaryngol Head Neck Surg,2011,144(1):78-84.
[16] Marqueling AL, Oza V, Frieden IJ, et al. Propranolol and infantile hemangiomas four years later: a systematic review [J]. Pediatr Dermatol,2013,30(2):182-191.
[17] Shayan YR, Prendiville JS, Goldman RD. Use of propranolol in treating hemangiomas [J].Can Fam Physician, 2011,57(3):302-303.