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New anticoagulants in children

Guy Young1

  • 1Children's Hospital Los Angeles, Los Angeles, CA 90027, USA. gyoung@chla.usc.edu

Hematology. American Society of Hematology. Education Program
|December 17, 2008
PubMed

Insights

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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