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Propranolol Versus Prednisolone for Treatment of Symptomatic Hemangiomas

Information source: Children's Research Institute
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Hemangioma of Infancy

Intervention: propranolol (Drug); Prednisolone (Drug)

Phase: Phase 2

Status: Recruiting

Sponsored by: Children's Research Institute

Official(s) and/or principal investigator(s):
Nancy M Bauman, MD, Principal Investigator, Affiliation: Children's Research Institute, Children's National Medical Center

Overall contact:
Jennifer Gode, RN, Phone: 202 476 4270, Email: jgode@cnmc.org

Summary

Hemangiomas are relatively common lesions in infants. Most go away spontaneously after one year of life and do not need treatment. Others require treatment because they cause significant symptoms such as pain, or difficulty with breathing, eating or ambulating.

Steroids have classically been used to treat hemangiomas and help to shrink them in 1/3 -

2/3 of patients. Unfortunately, steroids have many side effects in babies so physicians have sought other ways to treat them. Recently, the use of propranolol, a heart medication, was serendipitously found to reduce the size of hemangiomas. It appears to have many fewer side effects than steroids but it is not yet known if it works as well as steroids. This study seeks to compare the effect and the side effects of propranolol versus steroids for treating hemangiomas that cause symptoms in infants.

Clinical Details

Official title: Propranolol vs Prednisolone for Infant Hemangiomas-A Clinical and Molecular Study

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: reduction in size of hemangioma

Secondary outcome: Tolerability of medication

Detailed description: Infants with symptomatic hemangiomas will be enrolled. Magnetic resonance imaging will be completed before starting medication if the extent of the hemangioma is not evident on clinical examination alone. Infants will be randomized to receive either propranolol or steroids for 4-6 months. Hemangioma response will be measured and compared monthly as will tolerability of the medications. Additionally, urine specimens will be collected at each visit to determine if markers are present that can predict response to therapy. Additionally, any hemangiomas that are excised will be examined for genetic markers to aid in predicting response to therapy.

Eligibility

Minimum age: N/A. Maximum age: 5 Months. Gender(s): Both.

Criteria:

Inclusion Criteria:

- infants with symptomatic hemangiomas

Exclusion Criteria:

- asthma

- diabetes

- hypertension

- hypotension

- hypoglycemia

- liver failure

- previous treatment for hemangiomas

Locations and Contacts

Jennifer Gode, RN, Phone: 202 476 4270, Email: jgode@cnmc.org

Children's National Medical Center, Washington, District of Columbia 20111, United States; Recruiting
Jennifer Gode, RN, Phone: 202-476-4270, Email: jgode@cnmc.org
Nancy Bauman, MD, Phone: 202 476 4270
Additional Information

Related publications:

Pérez RS, Mora PC, Rodríguez JD, Sánchez FR, de Torres Jde L. [Treatment of infantile hemangioma with propranolol]. An Pediatr (Barc). 2010 Feb;72(2):152-4. doi: 10.1016/j.anpedi.2009.05.019. Epub 2009 Jul 23. Spanish.

Denoyelle F, Leboulanger N, Enjolras O, Harris R, Roger G, Garabedian EN. Role of Propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma. Int J Pediatr Otorhinolaryngol. 2009 Aug;73(8):1168-72. doi: 10.1016/j.ijporl.2009.04.025. Epub 2009 May 29.

Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taïeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med. 2008 Jun 12;358(24):2649-51. doi: 10.1056/NEJMc0708819.

Starting date: July 2009
Last updated: May 25, 2012

Page last updated: August 23, 2015

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