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Direct Oral Anticoagulants: Novel Approach for the Treatment of Thrombosis in Pediatric Patients?

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Abstract

Venous thromboembolism (VTE) is a rare, but life-threatening disease in those who have not reached their adulthood. This condition is usually treated with heparin or low molecular weight heparins which require parenteral administration and, in case of unfractionated heparin, also frequent laboratory monitoring and dose adjustment. Direct oral anticoagulants (DOACs)—direct thrombin inhibitor dabigatran, and direct oral factor Xa inhibitors rivaroxaban, apixaban, and edoxaban—are currently frequently used for the prevention and treatment of VTE in adult population. In fact, these agents offer several advantages compared to traditional agents, such as oral route of administration, short on-set and off-set of action, predictable pharmacologic profile with low risk of food and drug interactions, and no need for routine laboratory assessment of anticoagulant activity. However, clinical experience with these directly acting oral anticoagulants in pediatric population is very limited as these drugs had been tested and are used mostly in adult individuals. This article reviews the current data from pre- and post-marketing studies reporting the use of DOACs for the treatment of VTE in pediatric patients.

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Acknowledgements

This study was supported by project APVV (Slovak Research and Development Agency) 16-0020, and by project VEGA (Research Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic) 1/0549/19.

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Authors and Affiliations

  1. Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Ján Mikler

  2. Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 036 59, Martin, Slovak Republic

    Matej Samoš, Tomáš Bolek & Marián Mokáň

  3. National Centre of Hemostasis and Thrombosis, Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Ingrid Škorňová, Lucia Stančiaková & Ján Staško

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  1. Ján Mikler
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Correspondence to Matej Samoš.

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Mikler, J., Samoš, M., Bolek, T. et al. Direct Oral Anticoagulants: Novel Approach for the Treatment of Thrombosis in Pediatric Patients?. Pediatr Cardiol 40, 1431–1438 (2019). https://doi.org/10.1007/s00246-019-02159-3

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