Nadolol may be a safe and efficacious alternative for the treatment of infantile hemangiomas in infants who experience unresponsiveness or adverse events to propranolol, according to a study published online Nov. 8 in JAMA Pediatrics.

Elena Pope, M.D., from The Hospital for Sick Children at the University of Toronto, and colleagues compared oral propranolol with oral nadolol in infants aged 1 to 6 months with problematic infantile hemangioma. The analysis included 71 infants with hemangioma >1.5 cm on the face or ≥3 cm on another body part causing, or with potential to cause, functional impairment or cosmetic disfigurement.

The researchers found that the difference in infantile hemangioma between groups by t test was 8.8 for size and 17.1 for color in favor of the nadolol group, demonstrating that nadolol was noninferior to propranolol. At 52 weeks, results were similar (6.0 for size and 10.1 for color improvement). The coefficient of involution was 2.4 higher with nadolol versus propranolol for each doubling of time unit (week). Safety data were similar between the groups.

"Oral nadolol was noninferior to oral propranolol, indicating it may be an efficacious and safe alternative in cases of propranolol unresponsiveness or adverse events, or when faster involution is required," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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