Efficacy and Safety of Propranolol vs Atenolol in Infants wi
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Propranolol has become the first-line therapy for problematic infantile hemangiomas (IHs) that require systemic therapy. The JAMA Otolaryngology-Head & Neck Surgery study suggests atenolol can be considered a first-line treatment for infantile hemangiomas.

The study objective was to compare the efficacy and safety of propranolol vs atenolol in infants (between age 5 and 20 weeks) with problematic IHs who required systemic therapy.

This was a prospective, multicenter, randomized, controlled, open-label clinical trial conducted in collaboration among 6 separate investigation sites in China from February 1, 2015, to December 31, 2018. A total of 377 patients met the criteria for inclusion and were randomized to the propranolol (190) and atenolol (187) groups.

Of 377 participants, 287 were female, and the mean (SD) age was 10.2 weeks in the propranolol group and 9.8 weeks in the atenolol group.

--After 6 months of treatment, in the propranolol and atenolol groups, the overall response rates were 93.7% and 92.5%, respectively.

--At 1 and 4 weeks after treatment, and thereafter, the hemangioma activity score in the atenolol group aligned with the propranolol group.

--No differences between the propranolol group and the atenolol group were observed in successful initial responses, quality of life scores, complete ulceration healing times, or the rebound rate.

--Both groups presented a similar percentage of complete/nearly complete responses at 2 years.

--Adverse events were more common in the propranolol group, but the frequency of severe adverse events did not differ meaningfully between the groups.

In conclusion, when compared with propranolol, atenolol had similar efficacy and fewer adverse events in the treatment of infants with problematic IHs. The results suggest that oral atenolol can be used as an alternative treatment option for patients with IH who require systemic therapy.

Source: https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2778665