Itraconazole versus propranolol: therapeutic and pharmacologic effect on serum angiopoietin-2 in patients with infantile hemangioma

J Dermatolog Treat. 2022 Feb;33(1):105-110. doi: 10.1080/09546634.2019.1687822. Epub 2021 Oct 28.

Abstract

Background: The initial recommendation propranolol usage in managing infantile hemangioma was in 2008 followed by various researches assessing the dosage, efficacy, and other parameters. Itraconazole is a world-wide tolerated antifungal but only a few studies have focused on its assessment in the treatment of infantile hemangiomas (IH).

Objective: This study aimed to investigate the newly proposed antifungal drug ICZ and characterize different aspects of its usage as an antiangiogenic drug.

Methods: This was an interventional clinical trial to assess the efficacy of ICZ versus propranolol in the treatment of infantile hemangioma with studying the change in serum angiopoietin 2 (Ang2). A total of 36 pediatric patients were divided into two equal groups: firstly treated with oral itraconazole and secondly treated by oral propranolol.

Results: Response to treatment was observed using a modified IH score. In itraconazole-treated infants, good response was observed in 44.4% of the patients. This was slightly higher than the propranolol group which showed 22.2% with good response. We observed a decrease in serum ang2 level after usage of ICZ and propranolol and the change in serum Ang2 level before and after treatment in each group was statistically significant (p < .001).

Conclusion: Oral itraconazole can be an equivalent option for oral propranolol while safer and shorter treatment periods.

Keywords: Angiogenesis; biomarkers; differentiation; human model; proliferation.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / therapeutic use
  • Angiopoietin-2 / therapeutic use
  • Antifungal Agents / therapeutic use
  • Child
  • Hemangioma* / drug therapy
  • Humans
  • Infant
  • Itraconazole / therapeutic use
  • Propranolol / therapeutic use
  • Skin Neoplasms* / drug therapy
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Angiopoietin-2
  • Antifungal Agents
  • Itraconazole
  • Propranolol