Cardiovascular drugs in the treatment of infantile hemangioma

Table 1 List of publications on the role of beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in infantile hemangioma

Ref.	Study type	n	Median age(range)	CV drugs	Conclusions
Léauté-Labrèze et al[6]	Prospective, clinical trial	456	103.8 ± 31.0 d	Propranolol	Propranolol was effective at a dose of 3 mg/kg per day for 6 mo
Abarzua-Araya et al[48]	Randomized double-blind controlled trial	23	5.2 ± 3.5 mo (2-14 mo)	Atenolol vs Propranolol	Atenolol appears to be as effective as propranolol
Léauté-Labrèze et al[10]	Randomized double-blind controlled trial	14	12.5 wk	Propranolol	Propranolol may be given very early in infants with IH, to stop IH growth and thus prevent disabling scarring
Blanchet et al[47]	Case series	4	2 mo (1.5-3 mo)	Acebutolol	Acebutolol seems to present advantages for use in treating subglottic hemangiomas
Bauman et al[43]	Randomized investigator-blind controlled trial	19	2 wk-6 mo	Propranolol vs Prednisolona	Both medications show similar efficacy. Propranolol should be the first line of therapy for symptomatic IH unless contraindicated or unless future studies demonstrate severe adverse effects
Chan et al[45]	Randomized controlled trial	41	2.5 mo (5-24 mo)	Timolol	Topical timolol maleate 0.5% gel with a maximum dose of 0.5 mg per day is a safe and effective option for small superficial IHs that have not ulcerated and are not on mucosal surfaces
Pope et al[46]	Cohort- blinded study	19	4.5 mo (1-92 mo)	Nadolol vs Propranolol	Patients with proliferative IH, treated with oral nadolol for 6 mo, experienced almost complete involution of their tumor, which was significantly different from patients treated with propranolol
Tan et al[11]	Open-labelled observational trial	8	12.9 wk (5-22 wk)	Captopril	The response of IH to an ACEI supports a critical role for the RAS proteins in IH
Cristou et al[12]	Retrospective case series	17	7.5 mo (4.5-15 mo)	Captopril	The striking improvement observed with propranolol has not been replicated with captopril. ACEI is not involved in IH involution and the mechanism of action
Itinteang et al[13]	Basic research-In vitro	6	6 mo (4-8 mo)	Ramipril Losartan	Findings suggest a key regulatory role of AT I and AT II in promoting cellular proliferation in IH, and establish a role for ACEIs and ARBs in the proliferation of IH

ACEI: angiotensin-converting enzyme inhibitors; ARBs: Angiotensin-receptor blockers; AT I: Angiotensin I; IH: Infantile hemangioma.