Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas(version 2022)

doi:10.19438/j.cjoms.2022.04.001

Abstract

Abstract: Since 2008, propranolol has become the first-line treatment for infantile hemangiomas. Many researches have been reported on its treatment mechanism both at home and abroad, and several expert consensus or clinical practice guidelines have been formulated and published. In recent years, with the continuous accumulation of clinical experience, increasing number of basic research works, and deepening understanding of the pathogenesis of hemangioma and the mechanism of action of propranolol, it is necessary to update the expert consensus to be more consistent with clinical practice, in order to guide medication and management, provide scientific norms for the clinical use of propranolol in the treatment of infantile hemangiomas. This updated version mainly simplified the process of clinical examination, medication, and monitoring, making it more convenient and operable.

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, LIU Xue-jian. Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas(version 2022)[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(4): 313-319.

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] Léauté-Labrèze C, Harper JI, Hoeger PH.Infantile haemangioma[J]. Lancet, 2017, 390(10089):85-94.
[3] Goelz R, Poets CF.Incidence and treatment of infantile haemangioma in preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2015,100(1):F85-F91.
[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.
Zheng JW.Infantile hemangiomas: seldom wait and see[J].China Journal of Oral and Maxillofacial Surgery, 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-Labrèze 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.
Qin ZP, Liu XJ, Li KL, et al.Treatment of infantile hemangiomas with low-dose propranolol: evaluation of short-term efficacy and safety[J]. Chinese Journal of Medicine, 2009, 89(44):3130-3134.
[10] 郑家伟,王绪凯,秦中平,等.口服普萘洛尔治疗婴幼儿血管瘤中国专家共识[J].上海口腔医学,2016,25(3):257-260.
Zheng JW, Wang XK, Qin ZP, et al.Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas[J]. Shanghai Journal of Stomatology, 2016,25(3):257-260.
[11] 普萘洛尔治疗婴幼儿血管瘤共识专家小组.口服普萘洛尔治疗婴幼儿血管瘤专家共识[J].中华小儿外科杂志,2019,40(10):865-869.
Consensus Expert Panel on Propranolol for the Treatment of Infantile Hemangioma. Consensus on oral propranolol treatment for infantile hemangiomas[J]. Chinese Journal of Pediatric Surgery,2019,40(10):865-869.
[12] 王杞章,郑家伟.口服普萘洛尔治疗婴幼儿增殖期血管瘤:英国儿科皮肤病学会共识及临床指南[J].中国口腔颌面外科杂志,2020,18(6):548-552.
Wang QZ, Zheng JW.Oral propranolol in the treatment of proliferating infantile haemangiomas:British Society for Paediatric Dermatology consensus guidelines(translation version)[J].China Journal of Oral and Maxillofacial Surgery,2020,18(6):548-552.
[13] Storch CH, Hoeger PH.Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action[J]. Br J Dermatol, 2010, 163(2):269-274.
[14] Ji Y, Chen S, Xu C, et al.The use of propranolol in the treatment of infantile haemangiomas: an update on potential mechanisms of action[J]. Br J Dermatol,2015,172(1):24-32.
[15] Kleinman ME, Greives MR, Churgin SS, et al.Hypoxia induced mediators of stem/progenitor cell trafficking are increased in children with hemangioma[J]. Arterioscler Thromb Vasc Biol, 2007, 27(12):2664-2670.
[16] Kum JJ, Khan ZA.Mechanisms of propranolol action in infantile hemangioma[J]. Dermatoendocrinol, 2015, 6(1):e979699.
[17] Stiles J, Amaya C, Pham R, et al.Propranolol treatment of infantile hemangioma endothelial cells: a molecular analysis[J]. Exp Ther Med,2012,4(4):594-604.
[18] Kowalska M, Debek W, Matuszczak E.Infantile hemangiomas: an update on pathogenesis and treatment[J]. J Clin Med, 2021, 10(20):4631.
[19] 盐酸普萘洛尔口服溶液说明书[Z/OL].2021-06-25.http://www.propranolol-solution.com/col.jsp?id=121.
Instructions for propranolol hydrochloride oral solution[Z/OL].2021-06-25.http://www.propranolol-solution.com/col.jsp?id=121.
[20] 郑家伟,张凌,陈正岗.普萘洛尔治疗婴幼儿血管瘤专家共识[J].中国口腔颌面外科杂志, 2013,11(2):161-164.
Zheng JW, Zhang L, Chen ZG.Introduction to a consensus conference on the use of propranolol for infantile hemangioma[J]. China Journal of Oral and Maxillofacial Surgery, 2013,11(2):161-164.
[21] Smithson SL, Rademaker M, Adams S, et al.Consensus statement for the treatment of infantile haemangiomas with propranolol[J]. Australas J Dermatol, 2017,58(2):155-159.
[22] Caussé S, Aubert H, Saint-Jean M, et al.Propranolol-resistant infantile haemangiomas[J]. Br J Dermatol, 2013, 169(1):125-129.
[23] Liu C, Zhao Z, Wu H, et al.Effect of combined low-dose oral prednisone with beta-adrenergic receptor antagonists for refractory infantile hemangiomas: retrospective cohort study in 76 patients[J]. Ann Transl Med, 2019, 7(23):750.
[24] Sebaratnam D, Rodríguez Bandera AI, Wong LF, et al.Infantile hemangioma. part 2: management[J]. Am Acad Dermatol, 2021, 85(6):1395-1404.
[25] Tan ST, Itinteang T, Leadbitter P.Low dose propranolol for infantile haemangioma[J]. J Plast Reconstr Aesthet Surg, 2011,64(3):292-299.
[26] Siegfried EC, Keenan WJ, Al-Jureidini S.More on propranolol for hemangiomas of infancy[J]. N Engl J Med, 2008, 359(26):2846.
[27] 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.
[28] Shah SD, Baselga E, McCuaig C, et al. Rebound growth of infantile hemangiomas after propranolol therapy[J]. Pediatrics, 2016,137(4):e20151754.
[29] 中华医学会整形外科分会血管瘤和脉管畸形学组.血管瘤和脉管畸形的诊断及治疗指南(2019版)[J].组织工程与重建外科杂志,2019,15(5):277-317.
Chinese Medical Association plastic Surgery branch hemangioma and vascular malformation group. CSSVA guidelines for vascular snomalies 2019[J].Journal of Tissue Engineering and Reconstructive Surgery,2019,15(5):277-317.
[30] Love JN, Sikka N.Are 1-2 tablets dangerous? beta-blocker exposure in toddlers[J]. J Emerg Med, 2004,26(3):309-314.
[31] 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.
[32] Zhao ZL, Liu C, Zheng JW, et al.Oral atenolol treatment for infantile hemangiomas: clinical analysis of 133 consecutive patients[J]. Ann Transl Med, 2021, 9(2):116.
[33] 王琦,向波,吉毅,等.普萘洛尔与阿替洛尔治疗婴儿血管瘤的比较研究[J].中华皮肤科杂志,2016, 49(10):683-687.
Wang Q, Xiang B, Ji Y, et al.Propranolol versus atenolol in the treatment of infantile hemangioma:a comparative study[J]. Chinese Journal of Dermatology, 2016, 49(10):683-687.
[34] Pope E, Lara-Corrales I, Sibbald C, et al.Noninferiority and safety of nadolol vs propranolol in infants with infantile hemangioma: a randomized clinical trial[J]. JAMA Pediatr, 2022, 176(1):34-41.
[35] Laurens C, Abot A, Delarue A, et al.Central effects of beta-blockers may be due to oxide and hydrogen peroxide release independently of their ability to cross the blood-brain barrier[J]. Front Neurosci, 2019,13:33.
[36] 宫贺,徐大朋,李越霄,等.0.5%马来酸噻吗洛尔滴眼液联合普萘洛尔治疗婴幼儿血管瘤疗效分析[J].中国口腔颌面外科杂志,2014,12(5):441-445.
Gong H, Xu DP, Li XY, et al.Topical timolol maleate 0.5% ophthalmic solution combined with propranolol in the management of infantile hemangiomas[J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(5):441-445.
[37] Li G, Xu D, Tong S, et al.Oral propranolol with topical timolol maleate therapy for mixed infantile hemangiomas in oral and maxillofacial regions[J]. J Craniofac Surg, 2015, 53(9):836-840.
[38] Wu HW, Liu C, Wang X, et al.Topical application of 0.5% timolol maleate hydrogel for the treatment of superficial infantile hemangioma[J]. Front Oncol, 2017, 7:137.