Hémangiome infantile du nourrisson et propranolol : une " rév olution " thérapeutique. Revue de la littérature Infantile hemangioma and propranolol : a therapeutic " re volution ". Literature review
2013
Infantile hemangioma (IH) is the most common benign vascular tumour affecting children. Most infantile hemangiomas are self-limiting, but some require specific treatment. Propranolol has been proposed for the treatment of infantile hemangiomas. The aim of this study is to explore the mechanism of action of pr opranolol for the treatment of infantile hemangiomas and to demonstrate its safety and efficacy thr ough a re view of the literature. The non cardioselective beta-blocker propranolol has been used in a pediatric setting for 40 years and, since 2008, has a ne w indication. A c learly significant improvement has been observed in the condition of c hildren with complicated IH (10 %) treated with propranolol. This new indication has been widely described in the international literature. V arious explanations have been put forward f or the mechanism of action including a vasoconstrictor, antiangiogenic and apoptotic effect of propranolol on the different cells making up an IH. Overall tolerance is good and the efficacy markedl y superior to that of an y other treatments used for this purpose. In conclusion, with its good tolerance profile and superior efficacy ver sus all the other available therapies, propranolol can be considered to be a first-line treatment for complicated IH.
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