在单个儿科中心直接使用口服抗凝剂的现实世界经验
Gianna G Valenti1, Cynthia Sabo1, Michelle Hyde1
1Department of Pediatrics, Pediatric Hematology Oncology, Children's Hospital of Michigan, Detroit, Michigan, USA.
Pediatric blood & cancer
|March 7, 2024
概括
直接口服抗凝剂 (DOAC) 在儿科患者中显示出可比的出血率,但观察到静脉血栓栓塞的复发率更高. 严重的月经出血 (HMB) 是女性经期后需要进一步调查的重要结果.
科学领域:
- 儿科血液学 儿科血液学
- 药理学 药理学是指药理学的学科.
- 临床结果研究研究
背景情况:
- 儿科静脉血栓塞栓症 (VTE) 发生率显著上升,特别是在住院儿童中.
- 直接口服抗凝剂 (DOAC) 对儿科VTE的传统抗凝剂具有潜在的治疗优势.
- 了解DOAC在儿童中的实际有效性和安全性至关重要.
研究的目的:
- 评估现实世界流行病学数据和治疗DOACs的儿科患者的结果.
- 评估在DOAC治疗的儿童中发生的出血事件,复发的VTE和严重的月经出血 (HMB).
- 将研究结果与有关儿童群体中DOAC和其他抗凝血剂的现有文献进行比较.
主要方法:
- 在2013年1月1日至2022年12月31日期间接受DOAC治疗的65名儿科患者的回顾性评估.
- 使用SPSS统计软件分析患者人口统计,DOAC类型 (apixaban,rivaroxaban,dabigatran) 和临床结果.
- 描述性统计分析遵循2023年国际血栓形成和血液静止学会 (ISTH) 结果定义.
主要成果:
- 里瓦罗克萨班是最常被处方的DOAC (61.5%),其次是阿皮克萨班 (37%).
- 观察到的出血率较低:2%为重大出血,9%为临床相关的非重大出血,1.5%为轻微出血.
- 严重的月经出血 (HMB) 影响了所有患者的5%和经期后女性的19%. 复发性VTE发生在9.2%的患者中,其中大多数患者接受了里瓦洛克萨班治疗.
结论:
- 在儿科患者中,DOAC治疗显示出与以前的试验和其他抗凝药相比的出血率.
- 严重的月经出血 (HMB) 是月经后女性的一个显着结果,需要继续进行研究.
- 观察到的复发性VTE的更高率 (9.2%) 可能与持续的风险因素和延长的随访相关,需要进一步的多中心研究.
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