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New anticoagulants in children
1Children's Hospital Los Angeles, Los Angeles, CA 90027, USA. gyoung@chla.usc.edu
Hematology. American Society of Hematology. Education Program
|December 17, 2008
Summary
Pediatric thromboembolic events are rising, increasing anticoagulant use. Novel agents may offer improved safety and efficacy over traditional options like heparin and warfarin.
Area of Science:
- Pediatric Thrombosis and Anticoagulation
- Pharmacology and Therapeutics
Background:
- Increasing incidence of thromboembolic complications in pediatric patients.
- Widespread use of anticoagulants like heparin, low-molecular-weight heparins (LMWH), and warfarin in children.
- Limitations of traditional anticoagulants in pediatric populations.
Observation:
- Novel anticoagulants, including direct thrombin inhibitors and fondaparinux, show promise for pediatric use.
- Adult approvals for novel agents suggest potential for enhanced safety and efficacy.
- Limited pediatric data for novel agents, primarily case reports until recently.
Findings:
- Clinical trials for bivalirudin and argatroban (direct thrombin inhibitors) are complete.
- A clinical trial for fondaparinux (selective factor Xa inhibitor) is ongoing.
- This review compares traditional anticoagulants with novel agents and trial results.
Implications:
- Potential for improved treatment strategies for pediatric thromboembolism.
- Need for further research and clinical trials to establish safety and efficacy of novel agents in children.
- Guidance for clinicians on the evolving landscape of pediatric anticoagulation.
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