Atenolol Versus Propranolol in The Treatment of Infantile Hemangioma: A Randomized Controlled Trial

Authors

  • Tanvir Kabir Chowdhury Assistant Professor of Pediatric Surgery, Chittagong Medical College, Chattogram.
  • Md Afruzul Alam Resident Surgeon of Pediatric Surgery, Institute of Child and Mother Health, Matuail, Dhaka.
  • Rajib Khastagir Associate Professor of Pediatric Surgery, Chittagong Medical College, Chattogram.
  • Tahmina Akhter Chowdhury Assistant Professor of Pediatric Surgery, Chittagong Medical College, Chattogram.
  • Farhana Tabassum Junior Consultant of Gynecology and Obstetrics, Institute of Child and Mother Health, Matuail, Dhaka.
  • M A Mushfiqur Rahman Assistant Professor of Pediatric Surgery, Chittagong Medical College, Chattogram.
  • Mohammad Zonaid Chowdhury Assistant Registrar of Pediatric Surgery, Chittagong Medical College, Chattogram.

DOI:

https://doi.org/10.3329/jcmcta.v33i2.67307

Keywords:

Atenolol; Hemangioma Activity Score; Infantile hemangioma; Propranolol.

Abstract

Background: Propranolol, a nonselective beta-blocker is recommended for the treatment of Infantile Hemangiomas (IHs). However, this treatment is not risk-free and it cannot be applied to many patients because of respiratory comorbidities. Atenolol is a cardioselective beta-blocker and recently, some studies have reported their experience in using oral Atenolol in IHs. The aim of this study was to compare the outcome of Atenolol versus Propranolol in the treatment of IHs.

 Materials and methods: This randomized controlled trial was carried out in the Department of Pediatric Surgery of Chittagong Medical College Hospital from January 2020 to December 2020. 49 patients aged less than 7 years with a diagnosis of cutaneous IH were randomly assigned into two groups. Group A received oral Propranolol (2 mg/kg/day) and Group B received oral Atenolol (1 mg/kg/day). Follow-up was made at 1 month, 3 months and 6 months. Main outcome measures were changes in Hemangioma Activity Score (HAS) and adverse effects. 5 patients did not show up in any follow-up. Finally, a total of 44 patients (22 in Propranolol group and 22 in Atenolol group) were included in the analysis.

Results: There was no significant difference in age and sex between the groups. Mean age was 7.5 months in Group A and 11.5 months in Group B (p= 0.580). Pretreatment HAS was similar between groups (median 4.0 in Group A, 4.4 in Group B, p=0.208) and posttreatment HAS was also similar between two groups (median 1 in Group A, 0 in Group B, p=0.243). In Group A median hemangioma size reduced from 3.30 cm to 0.55 cm and from 3.28 cm to 0.76 cm in Group B, significantly size reduced in both groups (p=<0.001) after treatment. 9.1% of patients in Group A and 22.7% of patients in Group B had complete response but the difference was not significant (p=0.412). Although, patients in Group A had more adverse effects than Group B (18.2% vs 9.1%, p=0.945) and it was not statistically significant.

Conclusion: This study showed that Atenolol is as effective as Propranolol for treatment of IH with few adverse effects.

JCMCTA 2022 ; 33 (2) : 106-112

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Published

2022-12-31

How to Cite

Chowdhury, T. K. ., Alam, M. A. ., Khastagir, R. ., Chowdhury, T. A. ., Tabassum, F. ., Rahman, M. A. M., & Chowdhury, M. Z. . (2022). Atenolol Versus Propranolol in The Treatment of Infantile Hemangioma: A Randomized Controlled Trial. Journal of Chittagong Medical College Teachers’ Association, 33(2), 106–112. https://doi.org/10.3329/jcmcta.v33i2.67307

Issue

Vol. 33 No. 2 (2022)

Section

Papers and Originals