Propranolol Versus Prednisolone for Treatment of Symptomatic Hemangiomas
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Purpose
Hemangiomas are relatively common lesions in infants. Most go away spontaneously after one year of life and do not need treatment. Others require treatment because they cause significant symptoms such as pain, or difficulty with breathing, eating or ambulating. Steroids have classically been used to treat hemangiomas and help to shrink them in 1/3 - 2/3 of patients. Unfortunately, steroids have many side effects in babies so physicians have sought other ways to treat them. Recently, the use of propranolol, a heart medication, was serendipitously found to reduce the size of hemangiomas. It appears to have many fewer side effects than steroids but it is not yet known if it works as well as steroids. This study seeks to compare the effect and the side effects of propranolol versus steroids for treating hemangiomas that cause symptoms in infants.
| Condition | Intervention | Phase |
|---|---|---|
|
Hemangioma of Infancy |
Drug: propranolol Drug: Prednisolone |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Propranolol vs Prednisolone for Infant Hemangiomas-A Clinical and Molecular Study |
- reduction in size of hemangioma [ Time Frame: 4-6 months ] [ Designated as safety issue: No ]
- Tolerability of medication [ Time Frame: 4-6 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 70 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: propranolol for treatment of hemangiomas
Assessing efficacy and tolerability of propranolol in management of symptomatic hemangiomas
|
Drug: propranolol
propranolol 0.5 mg/kg p.o. QID x 4 - 6 months
|
|
Active Comparator: Prednisolone
Assessing efficacy and tolerability of prednisolone in management of symptomatic hemangiomas and comparing to propranolol.
|
Drug: Prednisolone
1.0 mg/kg p.o. BID x 4-6 months
Other Name: pediapred
|
Detailed Description:
Infants with symptomatic hemangiomas will be enrolled. Magnetic resonance imaging will be completed before starting medication if the extent of the hemangioma is not evident on clinical examination alone. Infants will be randomized to receive either propranolol or steroids for 4-6 months. Hemangioma response will be measured and compared monthly as will tolerability of the medications. Additionally, urine specimens will be collected at each visit to determine if markers are present that can predict response to therapy.
Additionally, any hemangiomas that are excised will be examined for genetic markers to aid in predicting response to therapy.
Eligibility| Ages Eligible for Study: | up to 5 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- infants with symptomatic hemangiomas
Exclusion Criteria:
- asthma
- diabetes
- hypertension
- hypotension
- hypoglycemia
- liver failure
- previous treatment for hemangiomas
Contacts and Locations| Contact: Jennifer Gode, RN | 202 476 4270 | jgode@cnmc.org |
| Contact: Nancy Bauman, MD | 202 476 4270 |
| United States, District of Columbia | |
| Children's National Medical Center | Recruiting |
| Washington, District of Columbia, United States, 20111 | |
| Contact: Jennifer Gode, RN 202-476-4270 jgode@cnmc.org | |
| Contact: Nancy Bauman, MD 202 476 4270 | |
| Principal Investigator: | Nancy M Bauman, MD | Children's Research Institute, Children's National Medical Center |
More Information
Publications:
| Responsible Party: | Children's Research Institute |
| ClinicalTrials.gov Identifier: | NCT00967226 History of Changes |
| Other Study ID Numbers: | IRB 4502, NIH grant number 10179326 |
| Study First Received: | August 26, 2009 |
| Last Updated: | May 25, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Children's Research Institute:
|
hemangioma |
Additional relevant MeSH terms:
|
Hemangioma Neoplasms, Vascular Tissue Neoplasms by Histologic Type Neoplasms Propranolol Methylprednisolone acetate Prednisolone acetate Prednisolone Methylprednisolone Methylprednisolone Hemisuccinate Prednisolone hemisuccinate Prednisolone phosphate Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses |
Pharmacologic Actions Antihypertensive Agents Adrenergic beta-Antagonists Adrenergic Antagonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Vasodilator Agents Anti-Inflammatory Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 22, 2013