There are only a few studies, retrospective and open RCTs which have compared the efficacy of these two drugs. In a recent multi-centric retrospective analysis of propranolol versus corticosteroids for IH, 110 children were studied. Sixty eight children received propranolol at a dose of 2 mg/kg/day for a mean period of 7.9 months (range, 3.5-14 months) and 42 received prednisolone at a dose of 4 mg/kg/day for a mean period of 5.2 months (range, 2.5-8.0 months). On comparing the outcome parameters, 56 of 68 (82%) on propranolol achieved clearance of 75% or more compared to only 12 of 42 (29%) patients in the steroid group (P < 0.01). Only 1 child in the propranolol group had side effect in contrast to all the cases in the steroid group (P < 0.01). Other outcome parameters such as the number of cases with ulceration [4 (6%) vs. 11 (26%); P < 0.01] and the number of cases who required surgical referral [8 (12%) vs. 12 (29%); P = 0.03] were also significantly lower in the propranolol group than in the steroid group.[42] In another retrospective study, 12 selected pairs of infants were compared. The mean duration of treatment in the steroid and propranolol groups was 12.7 months (range, 5-28 months) and 10.6 months (range, 7-13 months), respectively. Investigator rating after 1, 2 and 6 months of treatment suggested that the response to propranolol is significantly better than steroids. Using VAF, the mean improvement after 6 months of treatment in both groups was 44.8% and 78.7%, respectively (P < 0.001).[45] In an open RCT from India, the authors have compared the efficacy of oral propranolol versus steroids versus both in 30 children with IH. The children were treated for a minimum period of 3 months. Group A received propranolol (2-3 mg/kg/day), group B received prednisolone (1-4 mg/kg/day) and group C was treated with both. Children in groups A and C had a significantly earlier response (mean initial response time in group A - 4.1 days; Group C - 4.7 days vs. Group B - 9.8 days; P < 0.05). Flattening of the haemangioma lesion was also sooner and more significant in group A and C than in group B (P < 0.05). The mean reduction in the size was significant in group A and C at 3, 6 and 12 months while in group B it was significant only at 6 months. Groups B and C had higher number of complications.[46] From these reports, oral propranolol appears to be a better drug than steroids. However, prospective blinded RCTs will provide better understanding of its efficacy and safety.