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Acenocoumarol therapy in pediatric patients
M Bonduel1, G Sciuccati, M Hepner
1Departamento de Haematología-Oncología, Hospital de Pediatría 'Prof Dr Juan P. Garrahan', Combate de los Pozos 1881, Buenos Aires, Argentina. mbonduel@garrahan.gov.ar
Journal of Thrombosis and Haemostasis : JTH
|August 13, 2003
Summary
Acenocoumarol dosing in children is age-dependent, with infants requiring higher doses than teenagers. Age-adjusted loading doses help pediatric patients reach the target therapeutic range faster, reducing hospitalization.
Area of Science:
- Pediatric Pharmacology
- Pharmacokinetics
- Anticoagulant Therapy
Background:
- Acenocoumarol is a vitamin K antagonist anticoagulant.
- Establishing safe and effective dosing guidelines for pediatric patients is crucial.
- Previous studies on pediatric acenocoumarol dosing are limited.
Purpose of the Study:
- To establish age-specific guidelines for acenocoumarol administration in children.
- To determine optimal loading and maintenance doses for pediatric patients.
- To evaluate the efficacy and safety of an age-adjusted dosing regimen.
Main Methods:
- Prospective evaluation of 93 pediatric patients over 33 months.
- Dosing adjustments based on age groups: <1, 1-5, 6-10, and 11-18 years.
- Monitoring of time to achieve and maintain target therapeutic range (TTR).
Main Results:
- Loading doses varied significantly by age group, with infants requiring the highest doses.
- 80% of patients achieved TTR within one week using age-adjusted loading doses.
- No serious bleeding or thrombotic complications were reported.
Conclusions:
- Pediatric response to acenocoumarol is age-dependent.
- An age-adjusted loading dose regimen is effective in pediatric patients.
- This approach reduces the time to achieve therapeutic anticoagulation and shortens hospital stays.