A comparative analysis of growth and developmental outcomes in infants with proliferative hemangiomas treated with oral propranolol versus prednisone.
In a retrospective comparison of 150 infants with proliferative infantile hemangiomas, oral propranolol was associated with better short-term lesion response, fewer respiratory infections, and higher growth and neurodevelopmental measures than oral prednisone after 3–6 months.
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In a retrospective comparison of 150 infants with proliferative infantile hemangiomas, oral propranolol was associated with better short-term lesion response, fewer respiratory infections, and higher growth and neurodevelopmental measures than oral prednisone after 3–6 months.
Research significance
The reported observational evidence suggests that propranolol may provide a more favorable efficacy and short-term developmental profile than prednisone for proliferative infantile hemangiomas; whether propranolol itself improves development or instead avoids corticosteroid-related effects is an untested inference requiring prospective, confounder-controlled studies.
Source abstract
OBJECTIVE: To investigate the clinical efficacy, adverse reactions, and physical growth and neurodevelopment effects of oral propranolol in infants with proliferative hemangiomas and to compare these outcomes with those of oral prednisone. METHODS: A retrospective analysis was conducted on 150 infants with proliferative infantile hemangiomas (IHs) treated at our hospital between October 2023 and October 2025. On the basis of outpatient treatment regimens, 77 infants who received oral propranolol were included in the study group, and 73 infants who received oral prednisone were included in the control group. Clinical data, treatment outcomes, adverse reactions, height, weight, head circumference, and neurodevelopment (assessed by using the Gesell Developmental Scale) were collected from medical records. After 3-6 months of treatment, clinical efficacy was evaluated with the Achauer efficacy grading system, and adverse reactions, physical growth parameters, and neurodevelopmental indicators were compared between the two groups. RESULTS: After 3-6 months of treatment, the clinical efficacy in the study group was significantly better than that in the control group (p < 0.05). The incidence of common adverse reactions, including hypotension, hypoglycemia, constipation, diarrhea, and vomiting, did not significantly differ between the two groups (p > 0.05). However, the incidence of respiratory tract infections was significantly lower in the study group than in the control group (p < 0.05). The infants in the study group also had significantly greater height, weight, and head circumference than those in the control group (p < 0.05). Neurodevelopmental assessment showed that developmental quotients in gross motor, fine motor, adaptive behavior, language, and personal-social domains were all significantly higher in the study group than in the control group (p < 0.05). CONCLUSION: Compared with oral prednisone, oral propranolol demonstrates superior therapeutic efficacy in the treatment of proliferative IHs and is associated with fewer respiratory infections and better physical and short-term neurodevelopmental outcomes. These findings suggest that propranolol may offer advantages over prednisone in terms of efficacy, safety, and developmental outcomes, supporting its use as a preferred first-line therapy for proliferative IHs. However, given the limited sample size and short follow-up of this study, large prospective studies are warranted to confirm these observations.