The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma
Background: Although the role of oral propranolol in treating IH is now well-recognized worldwide, the variation of treatment effectiveness over time and patients adherence have not been documented among Saudi. Objective: To identify the variation of effectiveness over the treatment period and the a...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Journal of Dermatology and Dermatologic Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352241016300287 |
| _version_ | 1828366081170866176 |
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| author | Ayman Al-Jazaeri |
| author_facet | Ayman Al-Jazaeri |
| author_sort | Ayman Al-Jazaeri |
| collection | DOAJ |
| description | Background: Although the role of oral propranolol in treating IH is now well-recognized worldwide, the variation of treatment effectiveness over time and patients adherence have not been documented among Saudi.
Objective: To identify the variation of effectiveness over the treatment period and the adherence to treatment of oral propranolol among Saudi children treated for infantile hemangiomas (IH).
Patients and methods: Children presented for treatment of problematic IH between February 2012 and September 2015 were recruited in a prospective observational study of oral propranolol at 2 mg/kg/day. Data about patients’ adherence (categorized based compliance with the scheduled visits and treatment administration), lesion comparative response score (based on the relative improvement compared to previous visit) and possible side-effects were collected during follow-up. Treatment was stopped once the lesions failed to show significant improvement. Serial digital photography was used for response and final outcome assessments.
Results: Thirty-six cases were enrolled at a median (range) age of 6 (2–55) months. Cases were classified as 19 minor and 17 major, including 10 with ulcerations. Adherence was poor in 12 (33.3%), moderate in 4 (11.1%) and good in 19 (52.8%). Excluding the poorly adherent, the mean duration of treatment and follow up were 6 ± 3.4 and 7 ± 4.6 months, respectively. A mean comparative response score of 1.67 from a maximum of 2 was achieved during the first month of treatment, then gradually diminished reaching 0.19 and 0 at 8 and 10 months respectively. Patients who successfully completed 6 months of treatment (n = 19) were more likely to present with major lesions (68.4% vs. 33.3%, P = 0.047) and at an earlier median age (4 vs. 11 months, P = 0.018). Complete or near complete responses was 47% achieved. All ulcerated lesions healed at a median of 2 (1–4) months.
Conclusion: The most dramatic response to treatment appeared during the first month, then progressively diminished toward negligible benefits beyond 8 months. Adherence to treatment can pose a challenge to achieving satisfactory outcomes. |
| first_indexed | 2024-04-14T05:40:23Z |
| format | Article |
| id | doaj.art-a308e3b47f284b6e8a07e264608e73d9 |
| institution | Directory Open Access Journal |
| issn | 2352-2410 |
| language | English |
| last_indexed | 2024-04-14T05:40:23Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Dermatology and Dermatologic Surgery |
| spelling | doaj.art-a308e3b47f284b6e8a07e264608e73d92022-12-22T02:09:29ZengWolters Kluwer Medknow PublicationsJournal of Dermatology and Dermatologic Surgery2352-24102017-01-012111610.1016/j.jdds.2016.10.002The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangiomaAyman Al-JazaeriBackground: Although the role of oral propranolol in treating IH is now well-recognized worldwide, the variation of treatment effectiveness over time and patients adherence have not been documented among Saudi. Objective: To identify the variation of effectiveness over the treatment period and the adherence to treatment of oral propranolol among Saudi children treated for infantile hemangiomas (IH). Patients and methods: Children presented for treatment of problematic IH between February 2012 and September 2015 were recruited in a prospective observational study of oral propranolol at 2 mg/kg/day. Data about patients’ adherence (categorized based compliance with the scheduled visits and treatment administration), lesion comparative response score (based on the relative improvement compared to previous visit) and possible side-effects were collected during follow-up. Treatment was stopped once the lesions failed to show significant improvement. Serial digital photography was used for response and final outcome assessments. Results: Thirty-six cases were enrolled at a median (range) age of 6 (2–55) months. Cases were classified as 19 minor and 17 major, including 10 with ulcerations. Adherence was poor in 12 (33.3%), moderate in 4 (11.1%) and good in 19 (52.8%). Excluding the poorly adherent, the mean duration of treatment and follow up were 6 ± 3.4 and 7 ± 4.6 months, respectively. A mean comparative response score of 1.67 from a maximum of 2 was achieved during the first month of treatment, then gradually diminished reaching 0.19 and 0 at 8 and 10 months respectively. Patients who successfully completed 6 months of treatment (n = 19) were more likely to present with major lesions (68.4% vs. 33.3%, P = 0.047) and at an earlier median age (4 vs. 11 months, P = 0.018). Complete or near complete responses was 47% achieved. All ulcerated lesions healed at a median of 2 (1–4) months. Conclusion: The most dramatic response to treatment appeared during the first month, then progressively diminished toward negligible benefits beyond 8 months. Adherence to treatment can pose a challenge to achieving satisfactory outcomes.http://www.sciencedirect.com/science/article/pii/S2352241016300287HemangiomaPropranololDurationResponseAdherenceUlcerating |
| spellingShingle | Ayman Al-Jazaeri The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma Journal of Dermatology and Dermatologic Surgery Hemangioma Propranolol Duration Response Adherence Ulcerating |
| title | The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma |
| title_full | The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma |
| title_fullStr | The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma |
| title_full_unstemmed | The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma |
| title_short | The response pattern and adherence to oral propranolol among Saudi children treated for infantile hemangioma |
| title_sort | response pattern and adherence to oral propranolol among saudi children treated for infantile hemangioma |
| topic | Hemangioma Propranolol Duration Response Adherence Ulcerating |
| url | http://www.sciencedirect.com/science/article/pii/S2352241016300287 |
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