PMC:4134656 / 24820-27334
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4134656","sourcedb":"PMC","sourceid":"4134656","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4134656","text":"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 \u003c 0.01). Only 1 child in the propranolol group had side effect in contrast to all the cases in the steroid group (P \u003c 0.01). Other outcome parameters such as the number of cases with ulceration [4 (6%) vs. 11 (26%); P \u003c 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 \u003c 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 \u003c 0.05). Flattening of the haemangioma lesion was also sooner and more significant in group A and C than in group B (P \u003c 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.","tracks":[{"project":"2_test","denotations":[{"id":"25136206-21844428-58659604","span":{"begin":1028,"end":1030},"obj":"21844428"},{"id":"25136206-21995756-58659605","span":{"begin":1527,"end":1529},"obj":"21995756"},{"id":"25136206-24314186-58659606","span":{"begin":2335,"end":2337},"obj":"24314186"}],"attributes":[{"subj":"25136206-21844428-58659604","pred":"source","obj":"2_test"},{"subj":"25136206-21995756-58659605","pred":"source","obj":"2_test"},{"subj":"25136206-24314186-58659606","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#939aec","default":true}]}]}}