Evaluation of the effectiveness of dose adjustments based on beta-blockers in the management of infantile hemangioma

Introduction. Infantile hemangiomas (IH) are benign vascular tumors most frequently encountered in infants and in early childhood. Most of them regress spontaneously, but some require treatment, given their complications or serious forms. Pathophysiology is still controversial. Therapeutic management of high-risk IH is based on oral beta-blockers, which have revolutionized first-line treatment based on corticosteroid therapy. The objective of the study is to evaluate the effectiveness of dose adjustments based on beta-blockers in the management of IH and to identify the occurrence of adverse effects. Materials and methods. This is a retrospective, descriptive study of dose reductions of beta-blockers presented in capsule form. This study is carried out at the preparatory level of the Mother – Child laboratory of the Beni Messous University Hospital, Algeria from January 1st, 2020 to December 31th, 2021, using the register of dose reduction requests. Monitoring the effectiveness of dose adaptations for patients suffering from IH of all types was carried out at the ophthalmology department of Beni Messous University Hospital and the dermatology department of the Mustapha Pacha University Hospital based on medical files and health records. Results. The number of dose adaptations carried out is 9246 including 691 (10%) preparations based on beta-blockers; these included 476 (68%) propranolol and 50 (7%) atenolol. The cohort of 40 patients with IH showed a female predominance with a sex ratio of 0.14, the most frequent location of which was the head (52.5%). The age of onset of the tumor was after the first month of birth (60%) while the average age of initiation of treatment was estimated at 6 months. The average duration of oral treatment was 5.7 months. The effectiveness of the treatment was observed in 60% of cases; however, adverse effects were reported in 20% of patients. Conclusion. Oral beta-blockers made a therapeutic revolution in the treatment of IH. The development of more adapted dosage forms to the location of the tumor and better tolerated by the pediatric population is essential for the benefit of children.