Comparing the Clinical, Radiologic and Biochemical Effectiveness of Atenolol and Propranolol in the Treatment of Infantile Hemangioma - A Randomized Controlled Trial
64 Pages Posted: 19 Mar 2019More...
Background: In this randomized controlled study, we set out to compare effectiveness and safety of propranolol with atenolol, a non-selective lipophilic beta-blocker, in the management of infantile hemangiomas(IHs).
Materials and methods: Consecutive patients with complicated and/or cosmetically significant IHs were randomized into two groups- Group A was administered oral propranolol 2mg/kg/day while Group B received oral Atenolol 1mg/kg/day for 9 months. All patients were followed up at monthly intervals for clinical response using Physician Global Assessment (PGA) and Haemangioma Activity Score (HAS). Doppler ultrasonography (USG) and measurement of serum Hypoxia Inducible factor-1 alpha (HIF-1α) was performed at baseline and end of treatment.
Results: Forty patients were recruited after satisfying inclusion/exclusion criteria. Number of patients achieving PGA5 was comparable in Group A (14/20) and Group B (9/20; p=0.110). No statistically significant difference was observed in the change in HAS (p=0.941), and mean time taken to achieve PGA5 (p=0.250) between Group A and Group B. Short-term adverse-effect profile of the two drugs did not differ significantly (p=0.651). The two groups were comparable in terms of the degree of volume reduction on USG (p=0.866) and reduction in HIF-1α levels (p=0.825).
Conclusions: Propranolol and atenolol are comparable in efficacy when used in the management of IHs.
Trial Registration Number: The study was registered in ClinicalTrials.com (ClinicalTrials.gov Identifier: NCT03237637).
Funding: ‘Special Research Grant’ for MD thesis from PGIMER, Chandigarh.
Declaration of Interest: None.
Ethical Approval: This study was approved by the Institutional Ethics Committee of the Postgraduate Institute of Medical Education and Research, Chandigarh.
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