New developments in pediatric venous thromboembolism and anticoagulation, including the target-specific oral anticoagulants

Courtney A. Lyle, Robert F. Sidonio, Neil A. Goldenberg

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE OF REVIEW: Pediatric venous thromboembolism (VTE) can affect children of all ages, requiring considerable pharmacologic intervention and is often associated with significant morbidity. Current research efforts are directed toward the development of risk-stratified VTE prevention strategies employing pharmacologic thromboprophylaxis, the optimization of conventional anticoagulation, and the investigation of the safety and efficacy of target-specific oral anticoagulants (TSOACs) in children. RECENT FINDINGS: Recent research has considerably improved the understanding of risk factors of hospital-acquired VTE and how these factors may be employed in risk-stratified paradigms for VTE prevention in children. Additional insight has been gained in the optimization of conventional anticoagulants in special populations such as neonates and children with inflammatory conditions, and in improving the overall safety and compliance with periprocedural anticoagulation and the use of home International Normalized Ratio monitoring. Furthermore, the use of TSOACs has been described in children and is the focus of numerous ongoing clinical trials that are evaluating the safety and efficacy of these agents in children with VTE. SUMMARY: Identification of hospital-acquired VTE risk factors may inform pediatric VTE prevention strategies. Although initial use of TSOACs may be promising, investigation of safety and efficacy in children is still underway.

Original languageEnglish (US)
Pages (from-to)18-25
Number of pages8
JournalCurrent opinion in pediatrics
Volume27
Issue number1
DOIs
StatePublished - Feb 21 2015

Keywords

  • anticoagulant
  • children
  • pediatrics
  • prevention
  • thrombosis
  • treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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