Atenolol versus propranolol for the treatment of infantile hemangiomas: A randomized controlled study

Background: Infantile hemangiomas have a dramatic response to propranolol, a nonselective beta-blocker. However, this treatment is not risk-free and many patients are excluded because of respiratory comorbidities. Atenolol is a cardioselective beta-blocker that may have fewer adverse events. Objective: We sought to evaluate the effectiveness of atenolol against propranolol in a noninferiority trial. Methods: In all, 23 patients met the inclusion criteria and were randomized to receive either atenolol or propranolol. Thirteen patients were treated with atenolol and 10 with propranolol. Follow-up was made at baseline, 2 weeks, 4 weeks, and then monthly for 6 months. Results: Patients treated with atenolol had a complete response of 53.8% and 60% with propranolol, respectively. These results were nonsignificant (P = .68). Relevant adverse events were not reported. Limitations: The reduced number of patients could have influenced our results. Conclusion: Atenolol appears to be as effective as propranolol. We did not find significant differences between these results or any adverse events.