Sigurna primjena i učestalost nuspojava beta-blokatora u liječenju dojenačkih hemangioma

postgraduate specialist thesis

• Author: Ivana Đurić
• Mentor: Arnes Rešić (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Arnes Rešić (član povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2025-02-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja: Rad istražuje primjenu beta-blokatora, s naglaskom na propranolol i timolol, u liječenju
dojenačkih hemangioma (IH). Propranolol je lijek prvog izbora u terapiji dojenačkih hemangioma zbog svoje
sposobnosti brzog smanjenja njihove veličine i intenziteta boje, dok je timolol pokazao visoku učinkovitost u
liječenju manjih, površinskih hemangioma. Primjena ovih lijekova rezultirala je uglavnom dobrim ili odličnim
terapijskim odgovorom, uz minimalne nuspojave. Rad obuhvaća procjenu sigurnosnog profila ovih lijekova i
analizu nuspojava prijavljenih u EudraVigilance bazi podataka te naglašava ulogu kliničkog farmaceuta u
prevenciji nuspojava, edukaciji roditelja i prilagodbi terapije.
Materijal: Rad se oslanja na podatke iz sustavnog pregleda studija o pacijentima liječenim propranololom i
timololom za dojenačke hemangiome. Proveden je i pregled dosadašnjih prijavljenih nuspojava u EudraVigilance
bazi podataka, uz usporedbu s dostupnim literaturnim izvorima. Naglasak je stavljen na doziranje propranolola,
praćenje nuspojava te individualizirani pristup terapiji, osobito kod pacijenata s komorbiditetima.
Rezultati: Propranolol je pokazao visoku učinkovitost u brzom smanjenju veličine i boje hemangioma, dok je
timolol bio uspješan u liječenju manjih, površinskih dojenačkih hemangioma. Nuspojave su uglavnom bile
minimalne i nisu zahtijevale prekid terapije, ali su prijavljeni i slučajevi ozbiljnijih nuspojava poput hipotenzije,
bradikardije i hipoglikemije. Pregledom studija pokazana je važnost postupne prilagodbe doze, koja se pokazala
učinkovitom u svrhu boljeg podnošenja terapije i smanjenja nuspojava.
Zaključak: Beta-blokatori, posebno propranolol i timolol, učinkoviti su u liječenju dojenačkih hemangioma, s
dobrim sigurnosnim profilom. Preporučuje se kontinuirano praćenje pacijenata i prilagodba terapije, osobito kod
pacijenata s komorbiditetima. Potrebna su daljnja istraživanja kako bi se ispitali dugoročni učinci terapije i
usporedila primjena beta-blokatora s drugim terapijskim opcijama.

Abstract (english)

Objectives: This paper investigates the use of beta-blockers, with an emphasis on propranolol and timolol, in the
treatment of infantile hemangiomas (IH). Propranolol is the drug of first choice in the treatment of infantile
hemangiomas due to it's ability to rapidly reduce their size and color intensity, while timolol has shown high
efficacy in the treatment of smaller, superficial hemangiomas. The use of these drugs resulted in mostly good or
excellent therapeutic response, with minimal side effects. The paper includes an assessment of the safety profile
of these drugs and an analysis of side effects reported in the EudraVigilance database, and emphasizes the role of
the clinical pharmacist in the prevention of side effects, parent education and therapy adjustments.
Material: The paper used data from a systematic review of relevant studies that included patients treated with
propranolol and timolol for infantile hemangiomas. An overview of previously reported side effects in the
EudraVigilance database was also conducted, with a comparison with available literature sources. Emphasis is
placed on the dosing of propranolol, the monitoring of side effects and the individualized approach to therapy,
especially in patients with comorbidities.
Results: Propranolol showed high efficacy in rapidly reducing the size and color of hemangiomas, while timolol
was successful in the treatment of smaller, superficial infantile hemangiomas. Side effects were mostly minimal
and did not require discontinuation of therapy, but cases of more serious side effects such as hypotension,
bradycardia, and hypoglycemia were also reported. A review of studies showed the importance of gradual dose
adjustment, which proved to be effective in order to better tolerate therapy and reduce side effects.
Conclusion: Beta-blockers, especially propranolol and timolol, are effective in the treatment of infantile
hemangiomas, with a good safety profile. Continuous monitoring of patients and adjustment of therapy is
recommended, especially in patients with comorbidities. Further studies are needed to examine the long-term
effects of therapy and to compare the use of beta-blockers with other therapeutic options.

• Keywords: beta-blokatori; propranolol; timolol; dojenački hemangiom; nuspojave lijekova
• Keywords (english): beta-blockers; propranolol; timolol; infantile hemangioma; drug side effects
• Language: croatian
• URN:NBN: urn:nbn:hr:163:930859
• Study programme: Title: Clinical pharmacy - specialistic study - university study; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni specijalist kliničke farmacije (sveučilišni specijalist kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-04-07 13:30:18