Diseases and Abnormalities at or Before Birth

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Lymphatic Diseases

Neoplasms, Vascular Tissue

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Microcystic Lymphatic Malformation

Kaposiform Hemangioendothelioma

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Sirolimus

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Tannic Acid

Drop 5 ml of sirolimus oral solution and 5 g of dressing into the mixed bottle. Apply mixed gel of topical sirolimus to affected area. Use it twice a day for 6 months.

Oral dose of sirolimus is calculated according to body surface area. Take it twice a day for 6 months. Maintain the blood concentration of sirolimus at 5-15ng/ml.

We compare topical and oral use of sirolimus in the treatment of superficial complicted vascular anomalies. In experimental group, we administrate percutaneous sirolimus. Drop 5 ml of sirolimus oral solution and 5 g of dressing into the mixed bottle. Apply mixed gel of topical sirolimus to affected area. Use it twice a day for 6 months.

Percutaneous sirolimus

We compare topical and oral use of sirolimus in the treatment of superficial complicted vascular anomalies. In active comparator group, we administrate oral sirolimus. Oral dose of sirolimus is calculated according to body surface area. Take it twice a day for 6 months. Maintain the blood concentration of sirolimus at 5-15ng/ml.

Oral sirolimus

Kai Li, MD, PhD

Weili Yan, MD,PhD

Ying Gong, MD,PhD

Wei Yao, MD, PhD

Zuopeng Wang, MD,PhD

Yingjing Ding, MD

Hanlei Yan, MD

In this study, we investigate the safety and efficacy of topical sirolimus in the treatment of superficial complicated vascular anomolies.

Vascular anomaly is a kind of rare disease. According to histology, biological behavior and clinical manifestations, it can be divided into two categories: vascular tumor and vascular malformation.

mTOR inhibitors are proved with the properties of anti-proliferation and anti-angiogenesis. Therefore, they have been used in the treatment of vascular anomalies. Sirolimus, by its ability to prevent downstream protein synthesis and subsequent cell proliferation and angiogenesis, has become a novel and effective treatment. However, after the children reach complete response, there may still be skin manifestations that affect the appearance and cause psychological shadows. Therefore, intervention is required.

Studies have reported that topical sirolimus is effective in treating Kaposiform Hemangioendothelioma (KHE). It is absorbed through the skin, avoiding the first pass elimination effect of the liver. Fewer adverse reactions have been observed. In this study, we investigate the efficacy and safety of percutaneous administration of sirolimus in the treatment of superficial complicated vascular anomalies.

Percutaneous Administration of Sirolimus in the Treatment of Superficial Complicated Vascular Anomalies

Percutaneous Administration of Sirolimus in the Treatment of Superficial Complicated Vascular Anomalies: a Randomized Controlled Trial

Achauer BM et al. made the four-level standard as follows. Grade I: tumor size and skin lesion color regression ≤ 25%; grade II: tumor size and skin lesion color regression 25%-50%; grade III: tumor size and skin lesion color regression 50-75%; grade IV: tumor size and skin lesion color regression ≥75%. After 6 months of treatment, the pzrticipant will be evaluated. Grade I will be viewed as invalid. Grade II and grade III will be viewed as effective, and grade IV will be viewed as very effective. Those in grade Ⅱ, Ⅲ or Ⅳ will be calculated in effectiveness rate.

Measured by ultrosonic doppler flowmetery at follow-up

Adverse events will be reported according to Common Terminology Criteria for Adverse Events, version 4.0 (CTCAE v4.0). Incidence of complications such as oral ulcers, abnormal liver enzymes, infections will be recorded. It is defined as occurring if individual subject has any of the above complications during the 6-month intervention

Platelet count is one of the major indicators of response to treatment. It is supposed to be greater than 100×10\^9/L.

Children's Hospital of Fudan University

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Percutaneous Administration of Sirolimus in the Treatment of Superficial Complicated Vascular Anomalies	NCT04921722	Kaposiform Hema... Tufted Angioma Superficial Vas... Superficial Lym...	Percutaneous si... Oral sirolimus	0 Years - 18 Years	Children's Hospital of Fudan University
Percutaneous Administration of Sirolimus in the Treatment of Superficial Complicated Vascular Anomalies	NCT04921722	Kaposiform Hema... Tufted Angioma Superficial Vas... Superficial Lym...	Percutaneous si... Oral sirolimus	0 Years - 18 Years	Children's Hospital of Fudan University

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