Infantile Hemangioma (IH)Phase 4PROIHSTOPNCT07665177
Abrupt Discontinuation Versus Gradual Tapering of Propranolol in Infantile Hemangioma
A Phase 4 study testing Abrupt Discontinuation of Propranolol and Gradual Tapering of Propranolol in people with Infantile Hemangioma (IH), run by West China Hospital at 1 site in China.
Trial summary
Infantile hemangioma is the most common benign vascular tumor in infancy. Oral propranolol is the first-line systemic treatment for infantile hemangiomas requiring therapy. Although most patients respond well to propranolol, rebound growth may occur after treatment discontinuation, and some patients may require… Read more about this study
- Who is it for?
- Ages 6 to 60 months
- Conditions the study is for
- Infantile Hemangioma (IH)
- What is being tested?
- Abrupt Discontinuation of Propranolol and Gradual Tapering of Propranolol
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 110 participants
- Where
- 1 siteChina
- Study dates
- 1 Jul 2026to 30 Mar 2028
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 60 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Children with a clinical diagnosis of infantile hemangioma.
- Complete pretreatment clinical documentation is available, including clinical photographs and/or ultrasound findings.
- The child has received oral propranolol for at least 6 months.
- The infantile hemangioma meets the predefined criteria for propranolol discontinuation, defined as complete or near-complete clinical regression, no obvious residual blood flow on ultrasound, and stable maximal regression for 3 months.
- Written informed consent is provided by a parent or legal guardian.
- The parent or legal guardian is able and willing to complete the scheduled follow-up assessments.
Who cannot join
- Airway or hepatic infantile hemangiomas, or other high-risk lesions for which rebound growth could rapidly compromise life or vital organ function.
- Use of propranolol for arrhythmia, hypertension, or another cardiovascular indication.
- A history of rebound growth after prior discontinuation of propranolol.
- Laser therapy, sclerotherapy, surgery, systemic corticosteroids, or other systemic treatment within 3 months before randomization.
- Severe cardiac, respiratory, hepatic, renal, metabolic, or other systemic disease that may affect participant safety or study assessment.
- Inability to complete standardized photography, ultrasound assessment, or scheduled follow-up.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site
West China Hospital of Sichuan University
Chengdu, Sichuan, 610041
Yi Ji, MD PhD, +862885423453, jijiyuanyuan@163.com
About this study
Official title: Rebound Growth After Abrupt Discontinuation Versus Gradual Tapering of Propranolol in Infantile Hemangioma: A Multicenter Randomized Noninferiority Trial
Infantile hemangioma is the most common benign vascular tumor in infancy. Oral propranolol is the first-line systemic treatment for infantile hemangiomas requiring therapy. Although most patients respond well to propranolol, rebound growth may occur after treatment discontinuation, and some patients may require restarting propranolol or receiving additional treatment. In clinical practice, propranolol may be discontinued abruptly after the lesion meets discontinuation criteria, or gradually tapered over several weeks before complete discontinuation. However, high-quality randomized evidence comparing these two discontinuation strategies remains limited.
This multicenter randomized noninferiority trial aims to compare the risk of rebound growth after abrupt discontinuation versus gradual tapering of propranolol in patients with infantile hemangioma who have received oral propranolol for at least 6 months and meet predefined discontinuation criteria.
Read the detailed description
This is a prospective, multicenter, randomized, parallel-group, noninferiority trial designed to evaluate whether abrupt discontinuation of propranolol is noninferior to gradual tapering with respect to rebound growth in infantile hemangioma.
Eligible participants will be patients clinically diagnosed with infantile hemangioma who have received oral propranolol treatment for at least 6 months and meet predefined criteria for treatment discontinuation. The discontinuation criteria include complete or near-complete clinical regression of the lesion, no obvious blood flow on ultrasound, and maintenance of maximal regression for 3 months. Participants will be randomly assigned in a 1:1 ratio to either the abrupt discontinuation group or the gradual tapering group.
Participants in the abrupt discontinuation group will stop propranolol immediately after meeting the predefined discontinuation criteria. Participants in the gradual tapering group will receive half of the original total daily dose for the first 2 weeks, followed by one quarter of the original total daily dose for another 2 weeks, and propranolol will be discontinued in week 5.
All participants will be followed for at least 3 months after propranolol discontinuation. Demographic data, infantile hemangioma characteristics, treatment history, lesion size and color before and after treatment, rebound growth, major rebound growth, adverse events after discontinuation, age at rebound, interval from discontinuation to rebound, treatment after rebound, and parental satisfaction will be collected. Rebound growth will be assessed using standardized photographs and/or ultrasound by blinded outcome assessors.
The primary outcome is the proportion of participants with rebound growth after propranolol discontinuation. Rebound growth is defined as more than 20% regrowth in the external appearance of the infantile hemangioma, including changes in color and/or volume. Secondary outcomes include the proportion of participants with major rebound growth, age at rebound, time from discontinuation to rebound, treatment after rebound, adverse events after discontinuation, and parental satisfaction. Major rebound growth is defined as rebound growth requiring modification of oral propranolol treatment, including dose adjustment or restarting propranolol.
The planned sample size is 110 participants, with 55 participants in each group, allowing for an anticipated loss to follow-up rate.
- Conditions
- Infantile Hemangioma (IH)
- Being tested
- Abrupt Discontinuation of Propranolol, Gradual Tapering of Propranolol
- Keywords
- Infantile hemangioma, Propranolol, rebound growth
- Medical subject headings
- Hemangioma, Capillary
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Abrupt Discontinuation of PropranololDrug
Propranolol will be stopped immediately once the participant meets predefined discontinuation criteria, including complete or near-complete clinical regression, no obvious blood flow on ultrasound, and maintenance of maximal regression for 3 months.
Gradual Tapering of PropranololDrug
The propranolol dose will be reduced to half of the original total daily dose for the first 2 weeks, then reduced to one quarter of the original total daily dose for another 2 weeks, and propranolol will be discontinued in week 5.
| Study group | Role | What they receive |
|---|---|---|
| Abrupt Discontinuation Group | Experimental | Participants assigned to this group will discontinue propranolol abruptly after meeting predefined discontinuation criteria for infantile hemangioma. Receives: Drug: Abrupt Discontinuation of Propranolol |
| Gradual Tapering Group | Active comparator | Participants assigned to this group will undergo gradual tapering of propranolol before complete discontinuation after meeting predefined discontinuation criteria for infantile hemangioma. Receives: Drug: Gradual Tapering of Propranolol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Rebound Growth Following Propranolol Discontinuation
Rebound growth is defined as a greater than 20% increase in the visible extent of the infantile hemangioma after propranolol has been stopped, including change in color and/or volume. Rebound growth will be assessed by blinded outcome assessors using standardized clinical photographs and/or ultrasound.
Measured: Up to 3 months after complete discontinuation of propranolol
Secondary outcomes (4)
Time to Rebound Growth
Time to rebound growth will be defined as the interval from complete discontinuation of propranolol to the first documented evidence of rebound growth.
Measured: Up to 3 months after complete discontinuation of propranolol
Age at Rebound Growth
Age at rebound growth will be recorded as the participant's age at the first documented evidence of rebound growth.
Measured: Up to 3 months after complete discontinuation of propranolol
Post-Rebound Treatment
Treatment after rebound growth will be recorded, including observation, propranolol dose adjustment, reinitiation of propranolol, topical therapy, laser therapy, surgery, or other treatment.
Measured: Up to 3 months after complete discontinuation of propranolol
Incidence of Clinically Significant Rebound Growth
Clinically significant rebound growth is defined as rebound growth that leads to a change in oral propranolol management, including dose adjustment or reinitiation of propranolol.
Measured: Up to 3 months after complete discontinuation of propranolol
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jun 2026
- Study start1 Jul 2026 (estimated)
- Primary completion30 Dec 2027 (estimated)
- Study completion30 Mar 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Infantile Hemangioma (IH)Studies of the same condition, open and under way.
- More trials run by West China HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Parallel Assignment
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 110 participants (estimated)
Sponsor and investigators
- Lead sponsor
- West China Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yi Ji, West China Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07665177
- Sponsor's protocol ID
- RCT20260618
- Acronym
- PROIHSTOP
- Status last verified
- Jun 2026
- First submitted
- 18 Jun 2026
- Last updated
- 24 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be publicly shared because the dataset includes sensitive pediatric clinical information, clinical photographs, and ultrasound data. De-identified aggregate data may be made available from the principal investigator upon reasonable request and with appropriate ethical approval.
Study at a glance
From the registry record, last updated by the sponsor on 24 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Rebound Growth After Abrupt Discontinuation Versus Gradual Tapering of Propranolol in Infantile Hemangioma: A Multicenter Randomized Noninferiority Trial
- ClinicalTrials.gov ID
- NCT07665177
- Acronym / sponsor ID
- PROIHSTOP / RCT20260618
- Conditions
- Infantile Hemangioma (IH)
- Keywords
- Infantile hemangioma, Propranolol, rebound growth
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 110 participants (estimated)
- Lead sponsor
- West China HospitalUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 30 Dec 2027 (estimated)
- Study completion
- 30 Mar 2028 (estimated)
- First posted
- 24 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Infantile hemangioma is the most common benign vascular tumor in infancy. Oral propranolol is the first-line systemic treatment for infantile hemangiomas requiring therapy. Although most patients respond well to propranolol, rebound growth may occur after treatment discontinuation, and some patients may require restarting propranolol or receiving additional treatment. In clinical practice, propranolol may be discontinued abruptly after the lesion meets discontinuation criteria, or gradually tapered over several weeks before complete discontinuation. However, high-quality randomized evidence comparing these two discontinuation strategies remains limited.
This multicenter randomized noninferiority trial aims to compare the risk of rebound growth after abrupt discontinuation versus gradual tapering of propranolol in patients with infantile hemangioma who have received oral propranolol for at least 6 months and meet predefined discontinuation criteria.
Detailed description
This is a prospective, multicenter, randomized, parallel-group, noninferiority trial designed to evaluate whether abrupt discontinuation of propranolol is noninferior to gradual tapering with respect to rebound growth in infantile hemangioma.
Eligible participants will be patients clinically diagnosed with infantile hemangioma who have received oral propranolol treatment for at least 6 months and meet predefined criteria for treatment discontinuation. The discontinuation criteria include complete or near-complete clinical regression of the lesion, no obvious blood flow on ultrasound, and maintenance of maximal regression for 3 months. Participants will be randomly assigned in a 1:1 ratio to either the abrupt discontinuation group or the gradual tapering group.
Participants in the abrupt discontinuation group will stop propranolol immediately after meeting the predefined discontinuation criteria. Participants in the gradual tapering group will receive half of the original total daily dose for the first 2 weeks, followed by one quarter of the original total daily dose for another 2 weeks, and propranolol will be discontinued in week 5.
All participants will be followed for at least 3 months after propranolol discontinuation. Demographic data, infantile hemangioma characteristics, treatment history, lesion size and color before and after treatment, rebound growth, major rebound growth, adverse events after discontinuation, age at rebound, interval from discontinuation to rebound, treatment after rebound, and parental satisfaction will be collected. Rebound growth will be assessed using standardized photographs and/or ultrasound by blinded outcome assessors.
The primary outcome is the proportion of participants with rebound growth after propranolol discontinuation. Rebound growth is defined as more than 20% regrowth in the external appearance of the infantile hemangioma, including changes in color and/or volume. Secondary outcomes include the proportion of participants with major rebound growth, age at rebound, time from discontinuation to rebound, treatment after rebound, adverse events after discontinuation, and parental satisfaction. Major rebound growth is defined as rebound growth requiring modification of oral propranolol treatment, including dose adjustment or restarting propranolol.
The planned sample size is 110 participants, with 55 participants in each group, allowing for an anticipated loss to follow-up rate.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Parallel Assignment
| Arm | Type | Receives |
|---|---|---|
| Abrupt Discontinuation Group | Experimental | Drug: Abrupt Discontinuation of PropranololParticipants assigned to this group will discontinue propranolol abruptly after meeting predefined discontinuation criteria for infantile hemangioma. |
| Gradual Tapering Group | Active comparator | Drug: Gradual Tapering of PropranololParticipants assigned to this group will undergo gradual tapering of propranolol before complete discontinuation after meeting predefined discontinuation criteria for infantile hemangioma. |
Who may qualify
- Ages
- 6 to 60 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (6 listed)
- Children with a clinical diagnosis of infantile hemangioma.
- Complete pretreatment clinical documentation is available, including clinical photographs and/or ultrasound findings.
- The child has received oral propranolol for at least 6 months.
- The infantile hemangioma meets the predefined criteria for propranolol discontinuation, defined as complete or near-complete clinical regression, no obvious residual blood flow on ultrasound, and stable maximal regression for 3 months.
- Written informed consent is provided by a parent or legal guardian.
Key exclusion criteria (6 listed)
- Airway or hepatic infantile hemangiomas, or other high-risk lesions for which rebound growth could rapidly compromise life or vital organ function.
- Use of propranolol for arrhythmia, hypertension, or another cardiovascular indication.
- A history of rebound growth after prior discontinuation of propranolol.
- Laser therapy, sclerotherapy, surgery, systemic corticosteroids, or other systemic treatment within 3 months before randomization.
- Severe cardiac, respiratory, hepatic, renal, metabolic, or other systemic disease that may affect participant safety or study assessment.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Abrupt Discontinuation of PropranololPropranolol will be stopped immediately once the participant meets predefined discontinuation criteria, including complete or near-complete clinical regression, no obvious blood flow on ultrasound, and maintenance of maximal regression for 3 months. | Drug | Abrupt Discontinuation Group |
| Gradual Tapering of PropranololThe propranolol dose will be reduced to half of the original total daily dose for the first 2 weeks, then reduced to one quarter of the original total daily dose for another 2 weeks, and propranolol will be discontinued in week 5. | Drug | Gradual Tapering Group |
Primary outcome
Incidence of Rebound Growth Following Propranolol Discontinuation
Time frame: Up to 3 months after complete discontinuation of propranolol
Rebound growth is defined as a greater than 20% increase in the visible extent of the infantile hemangioma after propranolol has been stopped, including change in color and/or volume. Rebound growth will be assessed by blinded outcome assessors using standardized clinical photographs and/or ultrasound.
4 secondary outcomes
Time to Rebound Growth
Time frame: Up to 3 months after complete discontinuation of propranolol
Age at Rebound Growth
Time frame: Up to 3 months after complete discontinuation of propranolol
Post-Rebound Treatment
Time frame: Up to 3 months after complete discontinuation of propranolol
Incidence of Clinically Significant Rebound Growth
Time frame: Up to 3 months after complete discontinuation of propranolol
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Jun 2026.
- Individual participant dataSharing planned: No. Individual participant data will not be publicly shared because the dataset includes sensitive pediatric clinical information, clinical photographs, and ultrasound data. De-identified aggregate data may be made available from the principal investigator upon reasonable request and with appropriate ethical approval.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Abrupt Discontinuation of Propranolol and Gradual Tapering of Propranolol in people with Infantile Hemangioma (IH), run by West China Hospital at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 24 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Yi Ji, MD, PhD (862885423453, jijiyuanyuan@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Rebound Growth Following Propranolol Discontinuation (time frame: Up to 3 months after complete discontinuation of propranolol). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jun 2026.