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Anticoagulation in children: Making the most of little patients and little evidence

Guy Young1, Christoph Male2, C Heleen van Ommen3

  • 1Children's Hospital Los Angeles, University of Southern California Keck School of Medicine.

Blood Cells, Molecules & Diseases
|May 30, 2017
PubMed

Insights

Pediatric thrombotic events are rising, necessitating anticoagulation. Alternative agents like argatroban offer advantages over standard anticoagulants, addressing limitations in efficacy and administration for improved pediatric care.

Area of Science:

  • Pediatric Hematology
  • Pharmacology
  • Thrombosis Management

Background:

  • Increasing incidence of thrombotic complications in children.
  • Widespread use of anticoagulation therapy in pediatric patients.
  • Limitations of current standard anticoagulant agents.

Purpose of the Study:

  • Compare and contrast standard and alternative anticoagulant agents for pediatric use.
  • Identify appropriate clinical situations for utilizing alternative anticoagulants.
  • Evaluate the efficacy and safety of novel anticoagulants in children.

Main Methods:

  • Review of existing literature on pediatric anticoagulation.
  • Comparative analysis of pharmacokinetic and pharmacodynamic properties.
  • Presentation of prospective clinical trial data for alternative agents.

Main Results:

  • Standard anticoagulants (heparin, LMWH, VKAs) exhibit significant shortcomings.
  • Alternative agents (argatroban, bivalirudin, fondaparinux) demonstrate improved properties.
  • Clinical trial data support the use of alternative agents over standard ones.

Conclusions:

  • Alternative anticoagulants offer solutions to the limitations of standard agents.
  • Argatroban, bivalirudin, and fondaparinux show promise for pediatric anticoagulation.
  • Further adoption of alternative agents is supported by clinical evidence.

Keywords:
AnticoagulationArgatrobanBivalirudinChildrenFondaparinuxHeparinLow molecular weight heparinWarfarin

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