A COMPARATIVE STUDY OF TREATMENT OF HAEMANGIOMA WITH PROPRANOLOL AND ORAL PREDNISOLONE.

Corresponding Author:
Dr. Bornali Dutta,
C1, Crishna Cauvery Enclave,
D Neog Path,
Behind Dona Planet, ABC,
Guwahati-781005, Assam.
E-mail: dr.bornali.dutta@gmail.com

ABSTRACT

AIMS AND OBJECTIVES

Infantile Haemangiomas (IHs) are the most common soft tissue tumours of infancy, occurring in 4% to 10% of children under 1 year of age. Many treatment options exist ranging from the policy of “Benign neglect” to surgical excision. This retrospective study was done to evaluate the difference in efficacy, adverse effects of oral propranolol versus oral prednisolone in the treatment of potentially disfiguring or functionally threatening infantile haemangiomas and their recurrence after cessation of treatment.

SETTINGS AND DESIGN

Hospital record based study.

METHODS AND MATERIALS

A retrospective study was done on 60 patients of Infantile Haemangioma (IH) aged two weeks to one year of age involving both sexes. Patients who had received propranolol and oral prednisolone during the study period of 2012 to 2015 were selected and Group A and Group B comprised of thirty patients who had received propranolol (1 to 2.5 mg/kg/d) and oral prednisolone group (0.5-2 mg/kg/d) respectively for a minimum duration of 9 months. Parameters like dimension of the haemangioma, colour, consistency, ultrasonographic findings and photographic documentation were assessed from both hospital records and photographs available with the authors. A minimum of 80% improvement was considered as success with no relapse up to 1 month of stopping treatment.

Statistical analysis used: Descriptive statistical analysis and Fisher’s exact test by GraphPad Software Inc., San Diego, USA.

RESULTS

Mean initial reduction of size of infantile haemangiomas were significantly lower in propranolol treated group (In days) (6.6±3.5SD) than prednisolone treated group (9.66±4.9SD) (p<0.0169). The time taken for a change in consistency from the onset of treatment was significantly shorter for the propranolol treated patients (Median: 3.13±SD1.4), compared with prednisolone treated group (Median: 6.6±SD 3.9). In the propranolol group, a tendency for shorter ulcer duration was seen in patients starting the medicine at an earlier stage of disease. Flattening of the lesions were found more in Group A patients within 9 months of treatment compared to Group B (p=0.0641).

CONCLUSION

Propranolol had a consistent, rapid therapeutic effect compared to prednisolone with milder adverse effects and lower recurrence rate in the treatment of infantile haemangioma. Prednisolone was associated with a higher number of complications, thereby decreasing patient compliance. Propranolol reduced the duration of ulceration in IH and seemed to be more effective when started at an early phase. Further studies are needed in determining the most effective treatment dosage, optimum treatment duration and exact mechanism of action of propranolol in future.

KEYWORDS

Propranolol; Prednisolone, Beta-blocker, Infantile Haemangioma (IH), Ulceration, Adverse Effects.