- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01074437
Corticosteroids With Placebo Versus Corticosteroids With Propranolol Treatment of Infantile Hemangiomas (IH)
A Phase II, Randomized, Double-Blind Comparison of Corticosteroid and Corticosteroids With Propranolol Treatment of Infantile Hemangiomas (IH)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Infantile hemangiomas (IH) are the most common head and neck pediatric tumors. Presence of these tumors can lead to complications of vision and airway compromise, bleeding and disfigurement. Medical treatment of these lesions has traditionally been focused on stopping new blood vessel growth with corticosteroids. Recent reports and our own experience have demonstrated that significant reduction in IH size and vascularity can also occur through the use of propranolol. Our initial experience with propranolol has demonstrated significant efficacy with fewer side effects than corticosteroids. Despite this experience, the standard of care for initial IH medical therapy remains corticosteroids.
This Trial is a direct comparison of traditional IH therapy with corticosteroids to newer therapy with propranolol and corticosteroids.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Washington
-
Seattle, Washington, United States, 98105
- Seattle Children's Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 0 to < 9months
- Patients with clinical, radiographic or histologic diagnosis of infantile hemangioma (IH) requiring medical treatment
- IH patients whose parents desire medical treatment for the IH
- Stable cardiac function
Exclusion Criteria:
- IH patients over 9 months of age.
- Hypersensitivity to propranolol
- Untreated heart failure: If the patient has heart failure associated with the hemangioma, propranolol would be initiated after anti-congestive therapy and under observation as an in-patient.
- Atrioventricular (AV) block
- Resting heart < 2 SD of normal*(below)
- Resting blood pressure < 2 SD of normal**(below)
- Wolff-Parkinson-White syndrome (WPW)
- History of unexplained syncope
- Bronchial asthma
- History of impaired renal or liver function
- Diabetes mellitus
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Group A: Corticosteroid with Placebo
Group A will receive oral, liquid Prednisolone, which is the standard corticosteroid that we use here at Seattle Children's, and oral liquid placebo.
The dose of prednisolone that Group A will receive will be 1-2mg/kg/day for 7 days and then the dose will be slowly reduced and then stopped after 3 weeks.
This is a standard dose for IH treatment.
Gastric prophylaxis (Zantac) will be given to help prevent any stomach problems associated with prednisolone.
This treatment will be given for two months, as is our standard practice.
|
Oral liquid prednisolone.
Dose: 1-2mg/kg/day for 7 days, and then dose will be slowly reduced and then stopped after 3 weeks.
Other Names:
Liquid placebo will be given during the two month treatment trial.
Other Names:
|
Other: Group B: Corticosteroid with Propranolol
Group B will receive oral liquid prednisolone, and oral propranolol.
As in Group A, the dose of prednisolone will be 1-2mg/kg/day for 7 days and then the dose will be slowly reduced and then stopped after 3 weeks.
Oral liquid propranolol will be dosed at 2 mg/kg/day, following initiation in the Cardiology Clinic.
Gastric prophylaxis (Zantac) will be given to help prevent any stomach problems associated with prednisolone.
|
Oral liquid prednisolone.
Dose: 1-2mg/kg/day for 7 days, and then dose will be slowly reduced and then stopped after 3 weeks.
Other Names:
Oral liquid propranolol will be dosed Oral liquid propranolol will be dosed at 2 mg/kg/day.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare Changes in IH Size and Vascularity for the Two Treatment Groups
Time Frame: 1, 2, and 6 months after treatment initiation
|
This outcome cannot be evaluated.
Trial limited by lack of patient family to have randomization, which limited the number of participants and made the project nonviable.
|
1, 2, and 6 months after treatment initiation
|
Lesion Regression
Time Frame: 12 months
|
measure of change in lesion area or volume
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Determine Therapeutic Response of IH to Propranolol Among Patients Who Switch to Corticosteroids Plus Propranolol Therapy After Failing to Respond to Corticosteroids Alone.
Time Frame: 1, 2, and 6 months after treatment initiation
|
This outcome cannot be evaluated.
Trial limited by lack of patient family to have randomization, which limited the number of participants and made the project nonviable.
|
1, 2, and 6 months after treatment initiation
|
Assess the Safety of Propranolol With Corticosteroids and Corticosteroids Alone in the Treatment of IH.
Time Frame: 1, 2 and 6 months after treatment initiation
|
This outcome cannot be evaluated.
Trial limited by lack of patient family to have randomization, which limited the number of participants and made the project nonviable.
|
1, 2 and 6 months after treatment initiation
|
Demonstrate How Duplex Scanning to Assess Blood Vessel Density and Qualitative Color Ratings of Cutaneous Lesions From Photographs Can be Used to Measure and Quantify Changes in IH Size and Vascularity in a Clinically Relevant Manner.
Time Frame: 1, 2 and 6 months after treatment initiation
|
This outcome cannot be evaluated.
Trial limited by lack of patient family to have randomization, which limited the number of participants and made the project nonviable.
|
1, 2 and 6 months after treatment initiation
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jonathan A Perkins, DO, Seattle Children's Hospital
Publications and helpful links
General Publications
- Cushing SL, Boucek RJ, Manning SC, Sidbury R, Perkins JA. Initial experience with a multidisciplinary strategy for initiation of propranolol therapy for infantile hemangiomas. Otolaryngol Head Neck Surg. 2011 Jan;144(1):78-84. doi: 10.1177/0194599810390445.
- Truong MT, Perkins JA, Messner AH, Chang KW. Propranolol for the treatment of airway hemangiomas: a case series and treatment algorithm. Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):1043-8. doi: 10.1016/j.ijporl.2010.06.001. Epub 2010 Jul 31.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Congenital Abnormalities
- Skin Abnormalities
- Neoplasms, Vascular Tissue
- Hemangioma, Capillary
- Port-Wine Stain
- Hemangioma
- Physiological Effects of Drugs
- Adrenergic beta-Antagonists
- Adrenergic Antagonists
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Anti-Arrhythmia Agents
- Antihypertensive Agents
- Vasodilator Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Propranolol
- Prednisolone
Other Study ID Numbers
- 12901
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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