Duration of anticoagulant therapy in pediatric venous thromboembolism: Current approaches and updates from randomized controlled trials

Cristina Tarango, Sam Schulman, Marisol Betensky, Neil A. Goldenberg

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Compared with the incidence of venous thromboembolism in the adult population, pediatric VTE is rare. Yet, recent data suggest that the incidence of VTE in children is increasing, and little is known about the optimal duration of anticoagulation in pediatrics. Areas covered: This review summarizes current evidence-based adult recommendations and associated clinical trials from which current guidelines on the duration of anticoagulation in children have been extrapolated. It also discusses pediatric expert consensus-based guidelines and current pediatric clinical trials on duration of therapy in pediatric VTE. Expert commentary: The vast majority of pediatric VTE are provoked, and evidence on duration of anticoagulation for pediatric VTE is highly limited, but suggests that a maximum duration of 3 months is reasonable for most patients with provoked VTE, whereas longer duration is likely appropriate for unprovoked VTE. Whether shorter duration than 3 months is optimal for pediatric provoked VTE is as yet unclear. Results from the multinational randomized controlled trial studying the duration of anticoagulant therapy for provoked VTE in patients <21 years old (Kids-DOTT) will be critical to inform the future standard of care in pediatric VTE treatment.

Original languageEnglish (US)
Pages (from-to)37-44
Number of pages8
JournalExpert review of hematology
Volume11
Issue number1
DOIs
StatePublished - Jan 2 2018

Keywords

  • Duration of anticoagulation
  • guidelines
  • pediatrics
  • randomized trial
  • venous thromboembolism

ASJC Scopus subject areas

  • Hematology

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