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Purpose
Infantile haemangiomas are benign vascular neoplasms that can cause numerous functional or cosmetic problems. There has been developing interest in the use of propranolol in the treatment of infantile haemangioma as both first line and concurrent therapy with corticosteroids. We reviewed the roles of propranolol and corticosteroids in the treatment of haemangiomas.
Method
A literature review was performed for all articles published for haemangioma treatment using corticosteroids and Propranolol therapy from 1965 to May 2011. Articles were reviewed for reports of clinical cases, reported side effects, doses, duration of treatment, number of patients and response rate to treatment.
Results
Seven hundred and forty five studies were identified, out of which only 38 studies met our inclusion criteria comprising 2,697 patients being treated with local or oral steroids (19 studies) and 19 studies comprising 177 patients being treated with propranolol, out of which 82 (46.3%) patients had received prior corticosteroid therapy. Overall response rate to corticosteroids was 76.1% compared to 98.9% for all patients treated with Propranolol.
Statistical analysis using Chi-square demonstrates the isolated systemic Propranolol (91.0% resolution rate) administration to be superior to both oral corticosteroids therapy (1,219 out of 1,442 patients; 84.5% resolution rate) and local administration of corticosteroids (834 out of 1255 patients; 66.4% resolution rate) (p<0.0001) (Table 3).
Conclusion
Propranolol is an emerging therapy for infantile haemangioma with fewer side effects and greater efficacy than corticosteroid therapy. Present systematic review demonstrates that the regression of haemangioma when treated with Propranolol as first line therapy is consistently better than those treated with corticosteroids.