Prednisolone was the first-line therapy for hemangiomas for many years before propranolol was recognized as the treatment of choice in infantile hemangiomas. Both modalities have a 90% response rate.
Suppression of the hypothalamic-pituitary axis (HPA) was also a common side effect of prolonged prednisolone treatment. “Infants would require stress-dose steroids for illnesses and accidents for a period of time after therapy,” Dr. Morel says. “Immunization schedules would also be disrupted, as live virus vaccines cannot be given while on and for four weeks after steroid treatment. Routine immunizations given during steroid therapy may also need to be repeated.”
Risks from long-term steroids
Infants on long-term steroids are also at risk of hypertension and cardiomyopathy.
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