engleski

TREATMENT OF INFANTILE HEMANGIOMAS WITH NONSELECTIVE Β- ADRENERGIC RECEPTOR BLOCKERS AT THE CLINIC FOR CHILDREN’S DISEASES OF THE CLINICAL HOSPITAL CENTER SPLIT IN THE PERIOD 2010 - 2018

Infantile hemangiomas are benign vascular tumors. Tey are present in about 10% of infants. Non-selective β-blockers are drugs of choice for their treatment. Te cross-sectional retrospective study analyzed the results of the treatment of infantile hemangiomas in the period 01/01/2010 – 31/07/2018. Systemic treatment was carried out with propranolol, and locally with 0.5% timolol maleate. Propranolol was used in doses ranging from 2.0 mg to 3.0 mg/ kg / day (2.45 at the average) in three daily doses. It was prepared in pharmacies in the form of prescribed powders. More recently, registered propranolol preparation in the form of syrup has been used. Timolol maleate was used in the from 0.5% solution drops , 3 times a day topically on the hemangioma surface. Te length of treatment was determined by the clinical parameters of the semiquantitative hemangioma score. At the end of the treatment, success was evaluated by a modifed visual analogue scale (VAS) and the results of treatment were divided into successful, partially successful and unsuccessful. Te total of 493 children with infantile hemangiomas have been treated, out of whom 320 (65%) were females and 173 (35%) males. In 450 (91%) cases, treatment was initiated in the frst year of life, while in 322 (65%) cases it was started between the 2nd and 5th month of life. Te most common localizations were the head and neck (37%), followed by the torso in 29% of cases and the extremities in 27%. Te total of 73 (14.8%) patients had two or more hemangiomas in different areas of the body. Propranolol was applied in treatment in 287 (58%) subjects. Propranolol was applied as a single drug in 112 (23%) patients, and in combination with timolol in 175 (35%). Te total of 206 (42%) of children were treated topically with timolol maleate alone. Te length of treatment ranged from 5 to 28 months with a mean of 10.2 months. Te outcome of treatment with propranolol alone or in combination with timolol was successful in 261 (91%) cases, partially successful in 19 (6.5%) and unsuccessful in 7 (2.5%). Afer treatment with propranolol, 15 (5.2%) recurrences were registered. Te outcome of local treatment with timolol maleate was successful in 154 (75%) cases, in 45 (22%) cases it was partially successful and 7 (3%) cases unsuccessful, and only 1 (0.5%) case of relapse of hemangioma was recorded. Complications during local monotherapy with timolol maleate were not recorded, while during propranolol therapy complications were recorded in 12 (4.2%), with those necessitating discontinuation of treatment in 5 patients (1.7%) (2 cases due to hypoglycemia, 2 due to bronchial obstruction and 1 due to gastrointestinal manifestations). Te results of the study indicated good outcomes of treatment of infantile hemangiomas with non- selective β- adrenergic receptor blockers. Early onset of treatment and length of treatment, depending on the clinical evaluation of the appearance of hemangiomas, contribute to a lower number of recurrences. Timolol maleate as monotherapy is considered to be benefcial. It is no

Infantile hemangiomas, University Hospital Split, β-blockers

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