{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T10:35:50Z","timestamp":1772706950668,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T00:00:00Z","timestamp":1409702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Kristen Deane Scholarship"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Propranolol, now the preferred treatment for problematic proliferating infantile haemangioma (<jats:styled-content style=\"fixed-case\">IH<\/jats:styled-content>), at an empirical cardiovascular dosage of 2\u20133\u2009mg\/kg\/day is associated with variable complication rates. A meta\u2010analysis shows complications in 31% of patients at a mean dosage of 2.12\u2009mg\/kg\/day. This study reports on the minimal dosage and duration of treatment to achieve accelerated involution and side effects using a stepwise escalation regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with problematic proliferating <jats:styled-content style=\"fixed-case\">IH<\/jats:styled-content> treated with propranolol were identified from our vascular anomalies database. Propranolol was commenced at 0.5\u2009mg\/kg\/day in two divided doses and increased to 1\u2009mg\/kg\/day after 24\u2009h. The patients were reviewed after 1 week, and the dosage was increased to 1.5\u2009mg\/kg\/day. The dosage was further increased by 0.5\u2009mg\/kg\/day, if necessary, to achieve accelerated involution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four patients, aged 3 weeks to 11 months (mean, 3.8 months), received propranolol therapy for problematic proliferating <jats:styled-content style=\"fixed-case\">IH<\/jats:styled-content>. The minimal dosage required to achieve accelerated involution was 1.5\u20132\u2009mg\/kg\/day. Treatment was maintained for an average of 9.3 months and discontinued at an average age of 14.2 months. Rebound growth occurred in the first patient of this series when propranolol was withdrawn at 7.5 months of age, requiring reinstitution of treatment. Slight rebound growth following cessation of treatment was observed in four other patients, but reinstitution of propranolol was not required. Minor complications were observed in three (6.8%) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Propranolol at 1.5\u20132\u2009mg\/kg\/day, administered in divided doses with stepwise escalation, is safe and effective for treating problematic proliferating <jats:styled-content style=\"fixed-case\">IH<\/jats:styled-content>. Treatment is continued to an average age of 14.2 months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.12720","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T09:43:19Z","timestamp":1409737399000},"page":"419-424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Low\u2010dose propranolol regimen for infantile haemangioma"],"prefix":"10.1111","volume":"51","author":[{"given":"Cherise ES","family":"Tan","sequence":"first","affiliation":[{"name":"Gillies McIndoe Research Institute  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinte","family":"Itinteang","sequence":"additional","affiliation":[{"name":"Gillies McIndoe Research Institute  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Leadbitter","sequence":"additional","affiliation":[{"name":"Centre for the Study &amp; Treatment of Vascular Birthmarks Wellington Regional Plastic Maxillofacial and Burns Unit Hutt Hospital  Wellington New Zealand"},{"name":"Department of Paediatrics Hutt Hospital  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reginald","family":"Marsh","sequence":"additional","affiliation":[{"name":"Gillies McIndoe Research Institute  Wellington New Zealand"},{"name":"Waikato Campus Auckland University  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swee T","family":"Tan","sequence":"additional","affiliation":[{"name":"Gillies McIndoe Research Institute  Wellington New Zealand"},{"name":"Centre for the Study &amp; Treatment of Vascular Birthmarks Wellington Regional Plastic Maxillofacial and Burns Unit Hutt Hospital  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31821b63a0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.06.010"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12189"},{"key":"e_1_2_9_5_1","first-page":"57","article-title":"Steroid therapy for problematic infantile haemangioma","volume":"124","author":"Tan B","year":"2011","journal-title":"N. 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