Diagnosis and Management of Infantile Hemangioma

Table 16. Resolution outcomes in studies comparing beta-blockers (continued)
Author, Year
Comparison
Groups (n)
Quality
De Graaf et al,
2013 146-148
G1: Atenolol,
oral 1
mg/kg/day up
to 3 mg/kg (30)
G2:
Propranolol,
oral
2mg/kg/day
(historical
group) (28)
Quality: Fair
Age, Months
Type
Age, n (%)
1-6 months
G1: 12/24 (50)
G2: 23/27 (85)
6-12 months
G1: 8/24 (33)
G2: 4/27 (15)
Over 12 months
G1: 4/24 (17)
G2: 0
Type, n (%)
Localized/
nodular
G1: 19/24 (79%)
G2: 19/27 (70%)
Segmental
G1: 3/24 (13%)
G2: 2/27 (8%)
Indeterminate
G1: 2/24 (8%)
G2: 6/27 (22%)
Multifocal
G1: 0
G2: 0
Location
G1+G2:
multiple
Methods and
Measures of
Resolution/
Response
• Serial
photographs and
clinical
assessment of
involution (color
change, softening
to palpation and
reduction in size)
by blinded
assessors
• Visual analog
scale (VAS) and
hemangioma
activity score
(HAS)
Resolution
Outcomes
Clinical
involution, n (%)
G1: 27 (90)
G2: 28 (100)
VAS and HAS
scores shown in
figures only
G1 vs. G2
p= NS
Rebound
Growth/
Recurrence,
n (%)
G = group; HAS = hemangioma activity score; IH = infantile hemangioma; kg = kilogram; mg = milligram; n = number; NR =
not reported; NS = not significant; SD = standard deviation; VAS = visual analog scale
Nadolol Versus Propranolol
In a poor quality cohort study conducted in Canada, oral nadolol was used in the six month
treatment of 10 infants 1-month to 1-year of age and compared to a historical group of nine
similar infants matched for age and hemangioma location who were treated with oral propranolol
for at least six months (Table 17). 101 Infants were treated with oral nadolol starting at 0.5
mg/kg/day divided twice daily and increased weekly by 0.5 mg/kg to a maximum dose of 4
mg/kg/day (mean dose 2.19 ± 1.1 mg/kg). Propranolol was administered to a maximum of 2-3
mg/kg/day divided three times daily (mean dose 1.89 ± 0.29 mg/kg). The nadolol treated group
had a mean percentage IH shrinkage of 97 ± 3.05 percent at the 24-week visit compared with 86
± 14.82 percent shrinkage observed in the propranolol group (p< 0.001).
NR
52