{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:42:59Z","timestamp":1791664979067,"version":"4.3.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Propranolol for infantile hemangiomas (IHs) is effective and relatively safe. However, propranolol has different formulations and there is no consensus on the optimal formulation for IHs. The propranolol oral solution was not used in China until 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy and safety of propranolol tablets and an oral solution in infants with high-risk IH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted involving 234 consecutive patients with a clinical diagnosis of high-risk IH who were treated with propranolol between August 2018 and February 2023 (propranolol tablets, 168 patients; propranolol oral solution, 66 patients). All patients were assessed in the hospital at the initiation of treatment and in the outpatient setting during treatment. The Hemangioma Activity and Severity Index was used to monitor the clinical activity of the hemangioma after propranolol treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the Hemangioma Activity and Severity Index, 66.52% and 69.15% improvement occurred in the propranolol tablet and oral solution groups, respectively. 23.21% of patients in the propranolol tablet group and 42.42% in the oral solution group achieved &amp;gt;75% score improvement (<jats:italic>X<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20098.557; <jats:italic>P<\/jats:italic>\u2009=\u20090.003). Adverse reactions occurred in 34 (20.24%) and 11 patients (16.67%) in the propranolol tablet and oral solution groups, respectively. The most common adverse reaction in the propranolol tablet group was liver function abnormalities due to mild elevation of liver enzymes (<jats:italic>X<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20094.09; <jats:italic>P<\/jats:italic>\u2009=\u20090.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both propranolol tablets and oral solution had positive efficacy in patients with high-risk IHs, but more patients in the propranolol oral solution group achieve &amp;gt;75% score improvement compared to the propranolol tablet group. No life-threatening adverse reactions occurred in either group but liver function abnormalities were more likely to occur in patients treated with propranolol tablets.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1542348","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:33:07Z","timestamp":1738650787000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety assessment of propranolol tablets vs. oral solution for infantile hemangioma: a retrospective study in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenting","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingbing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1111\/j.1525-1470.2008.00626.x","article-title":"Infantile hemangiomas: how common are they? A systematic review of the medical literature","volume":"25","author":"Kilcline","year":"2008","journal-title":"Pediatr Dermatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.pcl.2018.12.011","article-title":"Diagnosis and management of infantile hemangiomas in the neonate","volume":"66","author":"Harter","year":"2019","journal-title":"Pediatr Clin North Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1056\/NEJMc0708819","article-title":"Propranolol for severe hemangiomas of infancy","volume":"358","author":"L\u00e9aut\u00e9-Labr\u00e8ze","year":"2008","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1056\/NEJMoa1404710","article-title":"A randomized, controlled trial of oral propranolol in infantile hemangioma","volume":"372","author":"L\u00e9aut\u00e9-Labr\u00e8ze","year":"2015","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/S0140-6736(16)00645-0","article-title":"Infantile haemangioma","volume":"390","author":"L\u00e9aut\u00e9-Labr\u00e8ze","year":"2017","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e20183475","DOI":"10.1542\/peds.2018-3475","article-title":"Clinical practice guideline for the management of infantile hemangiomas","volume":"143","author":"Krowchuk","year":"2019","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"4631","DOI":"10.3390\/jcm10204631","article-title":"Infantile hemangiomas: an update on pathogenesis and treatment","volume":"10","author":"Kowalska","year":"2021","journal-title":"J Clin Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1001\/jamapediatrics.2021.4565","article-title":"Noninferiority and safety of nadolol vs. propranolol in infants with infantile hemangioma: a randomized clinical trial","volume":"176","author":"Pope","year":"2022","journal-title":"JAMA Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.3390\/children11111397","article-title":"Diagnosis and treatment of infantile hemangioma from the primary care paediatricians to the specialist: a narrative review","volume":"11","author":"Bellinato","year":"2024","journal-title":"Children (Basel)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"879602","DOI":"10.3389\/fphar.2022.879602","article-title":"Update on treatment of infantile hemangiomas: what\u2019s new in the last five years","volume":"13","author":"Macca","year":"2022","journal-title":"Front Pharmacol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1111\/ijd.12646","article-title":"Hemangioma activity and severity index (HASI), an instrument for evaluating infantile hemangioma: development and preliminary validation","volume":"54","author":"Semkova","year":"2015","journal-title":"Int J Dermatol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.jaad.2021.08.020","article-title":"Infantile hemangioma. Part 2: management","volume":"85","author":"Sebaratnam","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1684\/ejd.2023.4484","article-title":"Propranolol for the treatment of infantile hemangiomas: a nine-year monocentric experience from a tertiary hospital","volume":"33","author":"Volont\u00e9","year":"2023","journal-title":"Eur J Dermatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"5956","DOI":"10.1038\/s41598-023-33105-2","article-title":"Safety of oral propranolol for neonates with problematic infantile hemangioma: a retrospective study in an Asian population","volume":"13","author":"Fu","year":"2023","journal-title":"Sci Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e20173783","DOI":"10.1542\/peds.2017-3783","article-title":"Safety of oral propranolol for infantile hemangioma","volume":"141","author":"Droitcourt","year":"2018","journal-title":"Pediatrics"},{"key":"B16","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1111\/bjd.13388","article-title":"The use of propranolol in the treatment of infantile haemangiomas: an update on potential mechanisms of action","volume":"172","author":"Ji","year":"2015","journal-title":"Br J Dermatol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1007\/s00383-018-4347-9","article-title":"Propranolol inhibits the activity of PI3K, AKT, and HIF-1\u03b1 in infantile hemangiomas","volume":"34","author":"Lin","year":"2018","journal-title":"Pediatr Surg Int"},{"key":"B18","doi-asserted-by":"publisher","first-page":"594","DOI":"10.3892\/etm.2012.654","article-title":"Propranolol treatment of infantile hemangioma endothelial cells: a molecular analysis","volume":"4","author":"Stiles","year":"2012","journal-title":"Exp Ther Med"},{"key":"B19","first-page":"I53","article-title":"Propranolol therapy in patients with acute myocardial infarction: the beta-blocker heart attack trial","volume":"67","author":"Goldstein","year":"1983","journal-title":"Circulation"},{"key":"B20","doi-asserted-by":"publisher","first-page":"104587","DOI":"10.1016\/j.phrs.2019.104587","article-title":"\u03b2-blockers: their new life from hypertension to cancer and migraine","volume":"151","author":"Fumagalli","year":"2020","journal-title":"Pharmacol Res"},{"key":"B21","first-page":"355","article-title":"Is propranolol compounding from tablet safe for pediatric use? Results from an experimental test","volume":"66","author":"Casiraghi","year":"2014","journal-title":"Minerva Pediatr"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e2021167","DOI":"10.1590\/1984-0462\/2023\/41\/2021167","article-title":"Compounded medications for cardiovascular use in neonatology: an integrative review","volume":"41","author":"Greenhalgh","year":"2023","journal-title":"Rev Paul Pediatr"},{"key":"B23","doi-asserted-by":"publisher","first-page":"adv00788","DOI":"10.2340\/actadv.v102.2021","article-title":"Aesthetic outcome of propranolol vs. atenolol treatment of children with infantile haemangioma","volume":"102","author":"Hermans","year":"2022","journal-title":"Acta Derm Venereol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1002\/cpdd.152","article-title":"Relative bioavailability of pediatric oral solution and tablet formulations of trametinib in adult patients with solid tumors","volume":"4","author":"Cox","year":"2015","journal-title":"Clin Pharmacol Drug Dev"},{"key":"B25","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1111\/j.1365-2710.1982.tb01034.x","article-title":"A bioequivalence study of three preparations of propranolol","volume":"7","author":"Mould","year":"1982","journal-title":"J Clin Hosp Pharm"},{"key":"B26","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1002\/bdd.2510100108","article-title":"Bioavailability of propranolol hydrochloride tablet formulations: application of multiple dose crossover studies","volume":"10","author":"Eldon","year":"1989","journal-title":"Biopharm Drug Dispos"},{"key":"B27","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1111\/pde.14966","article-title":"Safety of propranolol for infantile hemangioma in infants less than five weeks corrected age","volume":"39","author":"Gatts","year":"2022","journal-title":"Pediatr Dermatol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e941765","DOI":"10.12659\/AJCR.941765","article-title":"Excessively high chronic propranolol overdose in infantile hemangioma: a case report","volume":"24","author":"Alshammari","year":"2023","journal-title":"Am J Case Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1111\/ped.13249","article-title":"Acute liver dysfunction not resulting from hepatitis virus in immunocompetent children","volume":"59","author":"Tsunoda","year":"2017","journal-title":"Pediatr Int"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e15278","DOI":"10.1111\/ped.15278","article-title":"Severe hypoglycemia in propranolol treatment for infantile hemangiomas","volume":"64","author":"Morimoto","year":"2022","journal-title":"Pediatr Int"},{"key":"B31","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/s12887-019-1598-0","article-title":"Deep coma in a child treated with propranolol for infantile hemangioma","volume":"19","author":"Bakalli","year":"2019","journal-title":"BMC Pediatr"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.3390\/children11091086","article-title":"Assessing response rates and sleep disorder prevalence: insights from a propranolol treatment study for infantile haemangiomas","volume":"11","author":"Opri","year":"2024","journal-title":"Children (Basel)"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1542348\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:33:09Z","timestamp":1738650789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1542348\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":32,"alternative-id":["10.3389\/fped.2025.1542348"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1542348","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"article-number":"1542348"}}