Bosch Alessandra, Albisetti Manuela
Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
Division of Hematology, University Children's Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland.
Front Pediatr. 2022 Jul 4;10:932085. doi: 10.3389/fped.2022.932085. eCollection 2022.
Venous thromboembolism (VTE) has an increasing rate of significance in pediatric patients. The currently standardized anticoagulants (unfractionated heparin, low molecular weight heparin and vitamin K antagonists) and their dose regimens were not comprehensively trialed in pediatric patients. Recently, several direct oral anticoagulants (DOACs) have been studied in clinical trials in the pediatric population and further trials are ongoing. Dabigatran etexilate and rivaroxaban results show that these DOACs are safe and efficient in the treatment and secondary prevention of pediatric VTE. This review will focus on adverse events (AEs) between specific DOACs reported in the clinical trials in children and compare them to standard of care. This will assist clinicians in decision making of selecting the right anticoagulation for their pediatric patients.
静脉血栓栓塞症(VTE)在儿科患者中的重要性日益增加。目前标准化的抗凝剂(普通肝素、低分子量肝素和维生素K拮抗剂)及其剂量方案尚未在儿科患者中进行全面试验。最近,几种直接口服抗凝剂(DOACs)已在儿科人群的临床试验中得到研究,进一步的试验正在进行。达比加群酯和利伐沙班的研究结果表明,这些DOACs在儿科VTE的治疗和二级预防中是安全有效的。本综述将重点关注儿童临床试验中报告的特定DOACs之间的不良事件(AEs),并将其与护理标准进行比较。这将有助于临床医生为其儿科患者选择合适抗凝剂的决策。