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- W2968200046 abstract "Venous thromboembolism—comprising deep vein thrombosis, pulmonary embolism, and cerebral sinus venous thrombosis—is an emerging health-care problem in children. Since the first comprehensive report from the Canadian Registry of Venous Thromboembolism in children, 1 Andrew M David M Adams M et al. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood. 1994; 83: 1251-1257 Crossref PubMed Google Scholar the reported prevalence of venous thromboembolism has steadily increased, affecting up to 1 in 200 children being treated in tertiary paediatric hospitals. 2 Raffini L Huang YS Witmer C Feudtner C Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007. Pediatrics. 2009; 124: 1001-1008 Crossref PubMed Scopus (521) Google Scholar This increased incidence is attributed to advances in supportive care, specifically usage of central venous lines and awareness of venous thromboembolism in children. The current management of venous thromboembolism in children is not based on high-quality evidence. Clinical management of venous thromboembolism is derived from small studies, expert opinions, and registry data, relying upon removal of a risk factor and treatment with anticoagulation therapy, primarily low-molecular weight heparin or fondaparinux. This therapy is inconvenient because it requires parenteral administration, and frequent blood sampling to monitor medication for dose titration. The increased availability of direct oral anticoagulants (DOACs) for adults has been accompanied by efforts from the paediatric community to generate high-quality evidence of the safety and efficacy of DOACs in paediatric patients. The US Food and Drug Administration and the European Medicines Agency have been firm in their implementation of the US Pediatric Equity Act, and they have been keen to avoid off-label use of DOACs in children. This requirement has led to the development of clinical trial programmes for paediatric populations. Bodyweight-adjusted rivaroxaban for children with venous thromboembolism (EINSTEIN-Jr): results from three multicentre, single-arm, phase 2 studiesTreatment with bodyweight-adjusted rivaroxaban appears to be safe in children. The treatment regimens that we confirmed in children with bodyweights of at least 20 kg and the revised treatment regimens that we predicted in those with bodyweights less than 20 kg will be evaluated in the EINSTEIN-Jr phase 3 trial in children with acute venous thromboembolism. Full-Text PDF" @default.
- W2968200046 created "2019-08-22" @default.
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- W2968200046 date "2019-10-01" @default.
- W2968200046 modified "2023-10-13" @default.
- W2968200046 title "Changing landscape of anticoagulation therapy in children" @default.
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- W2968200046 doi "https://doi.org/10.1016/s2352-3026(19)30151-6" @default.
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