New Anticoagulants in Neonates, Children, and Adolescents

Abstract

Thrombotic events are an increasing challenge in pediatrics. Standard-of-care anticoagulants for pediatric thrombosis have several disadvantages which could be overcome by using direct oral anticoagulants (DOACs). Until recently, there was not enough evidence from clinical trials to recommend for or against the use of any of the four DOACs in children with thrombosis. In this literature review, we looked at the latest clinical trials in this field. On clinicaltrials.gov, we found 13 current studies with published results. For two of the four DOACs, namely dabigatran and rivaroxaban, we found successful phase III studies which led to the approval for the use in children. The results of these pivotal phase III studies allow to finally recommend rivaroxaban and dabigatran for the prophylaxis and treatment of thrombotic events in children.

Hemostaseology in Pediatrics

“…Dr. Halimeh guides us in her review "New Anticoagulants in neonates, children and adolescents" through the use of DOACs in children and their possible pitfalls. 14 V. Schmidt and M. Wildgruber provide in their review "Interventional Treatment Options in Children with Extracranial Vascular Malformations" a detailed overview on clinical presentation of venous, lymphatic, and arteriovenous malformations in children. 15 They evaluated critically the principles of endovascular treatment and their similarities between adult and pediatric practice, highlighting distinct differences regarding the treatment of vascular malformations of children, including dose limitations and procedure-related side effects.…”

“…Dr. Halimeh guides us in her review “New Anticoagulants in neonates, children and adolescents” through the use of DOACs in children and their possible pitfalls. 14…”