Anticoagulation Therapy in Children.
Review published in Seminars in thrombosis and hemostasis (2017)
Abstract
Venous thromboembolism (VTE) is very uncommon in children and adolescents compared with older adults, though its incidence has significantly increased over the past two decades. Given the rarity of the condition, the data on pediatric VTE lag behind the adult experience and consequently the management of VTE in children is, in large part, modeled on the adult strategies. This approach has certain limitations, given that young children have developmental particularities of the hemostatic system and differences in the pharmacokinetics and pharmacodynamics of various anticoagulant agents. The most commonly used anticoagulants in children continue to be the heparins and the vitamin K antagonists. Direct intravenous thrombin inhibitors, argatroban, bivalirudin, have very limited pediatric use. The non-vitamin K antagonist oral anticoagulant drugs (novel oral anticoagulants) present potential advantages in terms of efficacy, safety, and convenience, though pediatric data are limited to preclinical and small phase I trials. There are several ongoing phase I, II, and III trials for dabigatran rivaroxaban, apixaban, and edoxaban, the results of which are likely to change the future management of pediatric thromboses.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Venous thromboembolism (VTE) is very uncommon in children and adolescents compared with older adults, though its incidence has significantly increased over the past two decades. Given the rarity of the condition, the data on pediatric VTE lag behind the adult experience and consequently the...
Por qué esto importa para la hirudoterapia
Esta revisión aborda el manejo del tromboembolismo venoso (VTE) en niños y adolescentes, señalando que las estrategias de tratamiento se extrapolan en gran medida de datos en adultos a pesar de las diferencias hemostáticas propias del desarrollo. Discute el uso pediátrico limitado de inhibidores directos intravenosos de la trombina como el argatrobán y la bivalirudina, junto con los ensayos emergentes de nuevos anticoagulantes orales. La relevancia de este artículo para ASH reside en su discusión sobre la bivalirudina, un análogo sintético de la hirudina derivado de la saliva de la sanguijuela. Revisar la aplicación clínica y las limitaciones de los compuestos tipo hirudina en poblaciones pediátricas pone de relieve la continua importancia farmacológica de los mecanismos derivados de la sanguijuela. Sin embargo, el estudio no trata sobre sanguijuelas ni sobre hirudoterapia propiamente dicha, sirviendo únicamente como contexto amplio e indirecto sobre las terapias anticoagulantes relacionadas con el secretoma de la sanguijuela.
Citación
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026