Oral Propranolol: A New Treatment for Infants with Retinopathy of Prematurity?

Abstract:

INTRODUCTION:Oral propranolol has improved the treatment of infantile hemangiomas, and a pediatric oral solution of propranolol has recently been licensed in the USA and Europe. In very preterm infants, infantile hemangiomas are associated with the occurrence of retinopathy of prematurity (ROP), and both diseases share a peculiar time course, featuring a lag phase after birth followed by rapid growth and then gradual regression. OBJECTIVES:To identify clinical studies evaluating the use of oral propranolol in preterm infants with ROP. RESULTS:Two small bicentric, pilot, randomized controlled trials found a nonsignificant reduction of ROP requiring intervention by laser treatment or bevacizumab injection of similar magnitude. Together, 6 of 35 (17%) infants who had been receiving oral propranolol underwent ROP intervention, as opposed to 14 of 36 (39%) controls (relative risk 0.42, 95% CI: 0.15-1.16). Randomized controlled trials are ongoing that investigate early preventive oral propranolol starting at 1 week of age and propranolol eye drops in preterm infants with stage 2 ROP. CONCLUSION:Further, large interventional studies are required to determine the clinical benefit-risk ratio of oral propranolol to prevent vision-threatening ROP in very preterm infants.

journal_name

Neonatology

journal_title

Neonatology

authors

Bührer C,Bassler D

doi

10.1159/000381659

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

49-52

issue

1

eissn

1661-7800

issn

1661-7819

pii

000381659

journal_volume

108

pub_type

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