Christoph Bührer1, Dirk Bassler. 1. Department of Neonatology, Charité University Medical Center, Berlin, Germany.
Abstract
INTRODUCTION:Oral propranolol has improved the treatment of infantile hemangiomas, and a pediatric oral solution of propranolol has recently been licensed in the USA and Europe. In very preterm infants, infantile hemangiomas are associated with the occurrence of retinopathy of prematurity (ROP), and both diseases share a peculiar time course, featuring a lag phase after birth followed by rapid growth and then gradual regression. OBJECTIVES: To identify clinical studies evaluating the use of oral propranolol in preterm infants with ROP. RESULTS: Two small bicentric, pilot, randomized controlled trials found a nonsignificant reduction of ROP requiring intervention by laser treatment or bevacizumab injection of similar magnitude. Together, 6 of 35 (17%) infants who had been receiving oral propranolol underwent ROP intervention, as opposed to 14 of 36 (39%) controls (relative risk 0.42, 95% CI: 0.15-1.16). Randomized controlled trials are ongoing that investigate early preventive oral propranolol starting at 1 week of age and propranolol eye drops in preterm infants with stage 2 ROP. CONCLUSION: Further, large interventional studies are required to determine the clinical benefit-risk ratio of oral propranolol to prevent vision-threatening ROP in very preterm infants.
RCT Entities:
INTRODUCTION: Oral propranolol has improved the treatment of infantile hemangiomas, and a pediatric oral solution of propranolol has recently been licensed in the USA and Europe. In very preterm infants, infantile hemangiomas are associated with the occurrence of retinopathy of prematurity (ROP), and both diseases share a peculiar time course, featuring a lag phase after birth followed by rapid growth and then gradual regression. OBJECTIVES: To identify clinical studies evaluating the use of oral propranolol in preterm infants with ROP. RESULTS: Two small bicentric, pilot, randomized controlled trials found a nonsignificant reduction of ROP requiring intervention by laser treatment or bevacizumab injection of similar magnitude. Together, 6 of 35 (17%) infants who had been receiving oral propranolol underwent ROP intervention, as opposed to 14 of 36 (39%) controls (relative risk 0.42, 95% CI: 0.15-1.16). Randomized controlled trials are ongoing that investigate early preventive oral propranolol starting at 1 week of age and propranolol eye drops in preterm infants with stage 2 ROP. CONCLUSION: Further, large interventional studies are required to determine the clinical benefit-risk ratio of oral propranolol to prevent vision-threatening ROP in very preterm infants.
Authors: Hannes Hudalla; Thomas Bruckner; Johannes Pöschl; Thomas Strowitzki; Ruben-J Kuon Journal: Arch Gynecol Obstet Date: 2020-02-28 Impact factor: 2.344
Authors: Lauren A Dalvin; Mary Elizabeth Hartnett; Colin A Bretz; Cheryl R Hann; Ricky Z Cui; Alan D Marmorstein; David Sheikh-Hamad; Michael P Fautsch; Gavin W Roddy Journal: Curr Eye Res Date: 2019-08-28 Impact factor: 2.424