Direct Oral Anticoagulants: Novel Approach for the Treatment of Thrombosis in Pediatric Patients?

Venous thromboembolism (VTE) is a rare, but life-threatening disease in those who have not reached their adulthood. This condition is usually treated with heparin or low molecular weight heparins which require parenteral administration and, in case of unfractionated heparin, also frequent laboratory...

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Bibliographic Details
Published in:Pediatric cardiology 2019-10, Vol.40 (7), p.1431-1438
Main Authors: Mikler, Ján, Samoš, Matej, Bolek, Tomáš, Škorňová, Ingrid, Stančiaková, Lucia, Staško, Ján, Mokáň, Marián
Format: Article
Language:English
Subjects:
Administration, Oral
Anticoagulants (Medicine)
Cardiac Surgery
Cardiology
Child
Children
Clinical Trials as Topic
Comparative analysis
Dabigatran etexilate
Drug therapy
Factor Xa Inhibitors - administration & dosage
Factor Xa Inhibitors - pharmacology
Health aspects
Humans
Medicine
Medicine & Public Health
Pediatrics
Review Article
Thrombin
Thromboembolism
Vascular Surgery
Venous Thromboembolism - drug therapy
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Summary:Venous thromboembolism (VTE) is a rare, but life-threatening disease in those who have not reached their adulthood. This condition is usually treated with heparin or low molecular weight heparins which require parenteral administration and, in case of unfractionated heparin, also frequent laboratory monitoring and dose adjustment. Direct oral anticoagulants (DOACs)—direct thrombin inhibitor dabigatran, and direct oral factor Xa inhibitors rivaroxaban, apixaban, and edoxaban—are currently frequently used for the prevention and treatment of VTE in adult population. In fact, these agents offer several advantages compared to traditional agents, such as oral route of administration, short on-set and off-set of action, predictable pharmacologic profile with low risk of food and drug interactions, and no need for routine laboratory assessment of anticoagulant activity. However, clinical experience with these directly acting oral anticoagulants in pediatric population is very limited as these drugs had been tested and are used mostly in adult individuals. This article reviews the current data from pre- and post-marketing studies reporting the use of DOACs for the treatment of VTE in pediatric patients.
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-019-02159-3