Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey.

Wedgeworth, E, Glover, M, Irvine, A D, Neri, I, Baselga, E, Clayton, T H, Beattie, P E, Bjerre, J V, Burrows, N P, Foelster-Holst, R, Hedelund, L, Hernandez-Martin, A, Audrain, H, Bhate, K, Brown, S J, Baryschpolec, S, Darne, S, Durack, A, Dvorakova, V, Gach, J, Goldstraw, N, Goodyear, H, Grabczynska, S, Greenblatt, D, Halpern, J, Hearn, R M R, Hoey, S, Hughes, B, Jayaraj, R, Johansson, E K, Lam, M, Leech, S, O'Regan, G M, Morrison, D, Porter, W, Ramesh, R, Schill, T, Shaw, L, Taylor, A E M, Taylor, R, Thomson, J, Tiffin, P, Tsakok, M, Janmohamed, S R, Laguda, B, McPherson, T, Oranje, A P, Patrizi, A, Ravenscroft, J C, Shahidullah, H, Solman, L, Svensson, A, Wahlgren, C F, Hoeger, P H and Flohr, C (2016) Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey. The British journal of dermatology, 174 (3). pp. 594-601. ISSN 1365-2133. This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login.

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/bjd.142...

Abstract

BACKGROUND

Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres.

OBJECTIVES

The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.

METHODS

Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool.

RESULTS

The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of < 2 mg kg(-1) vs. 2 mg kg(-1) vs. > 2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend < 0·001.

CONCLUSIONS

The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login.
Subjects: WS Paediatrics. Child health
Divisions: Womens and Childrens > Paediatrics
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Depositing User: Mrs Yolande Brookes
Date Deposited: 02 Feb 2017 14:59
Last Modified: 02 Feb 2017 14:59
URI: http://www.repository.uhblibrary.co.uk/id/eprint/1151

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