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Anticoagulation Therapy in Children

Vlad Calin Radulescu1

  • 1Department of Pediatric Hematology Oncology, University of Kentucky, Lexington, Kentucky.

Seminars in Thrombosis and Hemostasis
|March 28, 2017
PubMed

Insights

Pediatric venous thromboembolism (VTE) management is largely based on adult data, despite developmental differences. New oral anticoagulants show promise, with ongoing trials poised to refine pediatric thrombosis treatment.

Area of Science:

  • Pediatric Hematology
  • Thrombosis and Hemostasis
  • Pharmacology

Background:

  • Venous thromboembolism (VTE) is rare in children but increasing.
  • Pediatric VTE management often extrapolates from adult data.
  • Children's unique physiology impacts anticoagulant effectiveness.

Purpose of the Study:

  • To review current pediatric VTE management strategies.
  • To highlight limitations of adult-based approaches in children.
  • To discuss the potential of novel oral anticoagulants in pediatric thrombosis.

Main Methods:

  • Literature review of pediatric VTE management.
  • Analysis of pharmacokinetic and pharmacodynamic data in children.
  • Overview of ongoing clinical trials for novel oral anticoagulants.

Main Results:

  • Heparins and vitamin K antagonists remain primary pediatric anticoagulants.
  • Limited pediatric data exists for direct thrombin inhibitors.
  • Novel oral anticoagulants demonstrate potential advantages but require more pediatric evidence.

Conclusions:

  • Current pediatric VTE treatment is suboptimal due to limited pediatric-specific data.
  • Novel oral anticoagulants (NOACs) are a promising area for future pediatric thrombosis care.
  • Ongoing clinical trials are crucial for establishing safe and effective NOAC use in children.

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