Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review
(1) Background: The incidence of thromboembolic events is relatively low in the general population, but it increases in hospitalized children and those who underwent thrombogenic procedures. Although the evidence regarding direct oral anticoagulants (DOACs) in children with venous thromboembolism (V...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/7/1093 |
| _version_ | 1827619117276856320 |
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| author | Stefana Maria Moisa Laura Mihaela Trandafir Crischentian Brinza Ingrith Crenguta Miron Elena Tarca Lacramioara Ionela Butnariu Alexandru Burlacu |
| author_facet | Stefana Maria Moisa Laura Mihaela Trandafir Crischentian Brinza Ingrith Crenguta Miron Elena Tarca Lacramioara Ionela Butnariu Alexandru Burlacu |
| author_sort | Stefana Maria Moisa |
| collection | DOAJ |
| description | (1) Background: The incidence of thromboembolic events is relatively low in the general population, but it increases in hospitalized children and those who underwent thrombogenic procedures. Although the evidence regarding direct oral anticoagulants (DOACs) in children with venous thromboembolism (VTE) is growing, DOACs were excluded from existing guidelines due to the lack of reliable data at that moment. Therefore, current evidence on VTE management in children needs to be critically reviewed. (2) Methods: We have conducted a literature search in the Scopus, EMBASE, and MEDLINE databases using prespecified keywords to retrieve studies published between 2010 and 2022. (3) Results: Clinical trials highlighted that rivaroxaban and dabigatran had predictable pharmacokinetic and pharmacodynamic profiles in children, similar to those observed in adults. Dabigatran and rivaroxaban had a similar safety profile to standard therapy but improved thrombotic burden and resolution during follow-up. Most studies involving apixaban and edoxaban are ongoing, and results are awaited. (4) Conclusions: Dabigatran and rivaroxaban could be valid therapeutic options for VTE management in children. In the case of apixaban and edoxaban, results from ongoing clinical studies are required before using them in pediatric VTE. |
| first_indexed | 2024-03-09T10:20:46Z |
| format | Article |
| id | doaj.art-e404f2b5af234ba9ae07375de3747211 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T10:20:46Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-e404f2b5af234ba9ae07375de37472112023-12-01T22:01:58ZengMDPI AGChildren2227-90672022-07-0197109310.3390/children9071093Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative ReviewStefana Maria Moisa0Laura Mihaela Trandafir1Crischentian Brinza2Ingrith Crenguta Miron3Elena Tarca4Lacramioara Ionela Butnariu5Alexandru Burlacu6Pediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, RomaniaPediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaPediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, RomaniaPediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, RomaniaPediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania(1) Background: The incidence of thromboembolic events is relatively low in the general population, but it increases in hospitalized children and those who underwent thrombogenic procedures. Although the evidence regarding direct oral anticoagulants (DOACs) in children with venous thromboembolism (VTE) is growing, DOACs were excluded from existing guidelines due to the lack of reliable data at that moment. Therefore, current evidence on VTE management in children needs to be critically reviewed. (2) Methods: We have conducted a literature search in the Scopus, EMBASE, and MEDLINE databases using prespecified keywords to retrieve studies published between 2010 and 2022. (3) Results: Clinical trials highlighted that rivaroxaban and dabigatran had predictable pharmacokinetic and pharmacodynamic profiles in children, similar to those observed in adults. Dabigatran and rivaroxaban had a similar safety profile to standard therapy but improved thrombotic burden and resolution during follow-up. Most studies involving apixaban and edoxaban are ongoing, and results are awaited. (4) Conclusions: Dabigatran and rivaroxaban could be valid therapeutic options for VTE management in children. In the case of apixaban and edoxaban, results from ongoing clinical studies are required before using them in pediatric VTE.https://www.mdpi.com/2227-9067/9/7/1093thrombosispediatricdirect oral anticoagulantsguidelinesoff-label |
| spellingShingle | Stefana Maria Moisa Laura Mihaela Trandafir Crischentian Brinza Ingrith Crenguta Miron Elena Tarca Lacramioara Ionela Butnariu Alexandru Burlacu Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review Children thrombosis pediatric direct oral anticoagulants guidelines off-label |
| title | Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review |
| title_full | Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review |
| title_fullStr | Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review |
| title_full_unstemmed | Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review |
| title_short | Current Antithrombotic Therapy Strategies in Children with a Focus on Off-Label Direct Oral Anticoagulants—A Narrative Review |
| title_sort | current antithrombotic therapy strategies in children with a focus on off label direct oral anticoagulants a narrative review |
| topic | thrombosis pediatric direct oral anticoagulants guidelines off-label |
| url | https://www.mdpi.com/2227-9067/9/7/1093 |
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