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Year : 2013  |  Volume : 14  |  Issue : 1  |  Page : 19-22

Use of oral prednisolone with or without propranolol in the management of infantile hemangioma: A critical appraisal

Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Minu Bajpai
Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2319-7250.116848

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Introduction: Various medications have been tried to induce regression in hemangioma. We tried to find out the benefits of oral prednisolone versus propranolol in these lesions. Objectives: The objective of this study was to assess the effect of oral prednisolone and propranolol in infantile hemangioma (IH) and also to compare their efficacy. Materials and Methods: This was a prospective study from January 2008 to December 2012. Patients of hemangioma in high risk location with dimension >5 cm and/or area >20 cm 2 were included. Patients were randomized into Group A receiving oral prednisolone 5 mg/kg/day in tapering doses, Group B receiving oral propranolol 3 mg/kg/day and Group C receiving both. Patients were evaluated for response and P < 0.05 was considered to be significant. Results: A total of 69 cases were included. Patients in each group were 24, 22 and 23 respectively. Mean age at presentation was 32 weeks (range 6-48 weeks). Therapy was initiated at 30.1 ± 9.2 weeks for 14.9 ± 2.1 weeks. Average tumor size at initiation was 28.2 ± 5.6 cm 2 in Group A, 24.9 ± 2.2 cm 2 in B and 22.7 ± 2.1 cm 2 in C. There was a significant response to treatment in Group A (P = 0.04) and insignificant in B (P = 0.07) and C (P = 0.06). Conclusions: Oral prednisolone is a viable treatment option in the management of high risk IH and there is no added benefit of using propranolol either alone or in combination in the treatment of these cases. A large randomized controlled trial is needed to further validate this observation.

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