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DOI: 10.1055/a-1740-7080
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.
Zusammenfassung
Thrombotische Ereignisse stellen in der Kindermedizin eine zunehmende Herausforderung dar. Die Standardantikoagulanzien für pädiatrische Thrombosen haben mehrere Nachteile, die durch den Einsatz direkter oraler Antikoagulanzien (DOACs) überwunden werden könnten. Bis vor kurzem war aber noch nicht ausreichend Evidenz aus klinischen Studien verfügbar, um evidenzbasierte Empfehlungen für den Einsatz einer der vier DOACs bei Kindern mit Thrombosen zu geben. In dieser Literaturübersicht haben wir die neuesten klinischen Studien auf diesem Gebiet untersucht. Auf clinicaltrials.gov fanden wir 13 aktuelle Studien mit veröffentlichten Ergebnissen. Für zwei der vier DOACs, namentlich Dabigatran und Rivaroxaban, fanden wir erfolgreiche Phase-III-Studien, die zur Zulassung für den Einsatz bei Kindern führten. Die Evidenz aus diesen zulassungsrelevanten Phase-III-Studien gestattet es daher jetzt, Rivaroxaban und Dabigatran für die Vorbeugung und Behandlung von thrombotischen Ereignissen bei Kindern zu empfehlen.
Keywords
pediatric medicine - thrombosis - heparins - vitamin K antagonists - direct oral anticoagulantsSchlüsselwörter
Kinderheilkunde - Thrombose - Heparin - Vitamin-K-Antagonisten - direkte orale AntikoagulanzienPublication History
Received: 08 December 2021
Accepted: 14 January 2022
Article published online:
29 April 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
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