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Anticoagulation Reversal in Pediatric Population Survey
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Anticoagulation Reversal in Pediatric Population Survey


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Description Abstract:

Vitamin K antagonists (VKA) such as warfarin, have been the main stay of oral anticoagulation (OAC) in pediatrics for a variety of therapeutic and prophylactic indications. However, VKA have a slow onset and offset, show multiple drug interactions, influenced by dietary intake, require regular monitoring and challenging access to age-appropriate administration forms and dose strengths. The pharmacological properties of direct oral anticoagulants (DOACs) and clinical results from adult trials suggest that this groauthorizations for some of the DOACs is expected by early 2020’s. However, the off label use of DOACs is also on the rise within the pediatric population.

up of drugs may have advantages particularly suitable for children: oral administration, predictable pharmacokinetics, no food interaction, fewer drug interactions, wider therapeutic window, and possibly no monitoring requirements. All of the currently approved DOACs in adults have pediatric developments ongoing or planned, some of which have substantially progressed into phase 3 studies and pediatric market 

Approximately 4-6% of patients treated with VKA and DOACs will suffer from major hemorrhage or be in need for urgent surgery necessitating anticoagulant reversal therapy. There are many options for VKA reversal including vitamin K (oral, SQ, IM and IV), 4-factor prothrombin complex concentrate and plasma, however, there are no specific guidelines in pediatrics. Similarly, the recent approval of andexanet4, a specific reversal agent for Factor Xa inhibitors and the availability of idarucizumab for dabigatran in adults only; there is lack of uniform guidelines for management of DOACs related bleeding in pediatrics. Therefore, we are conducting a brief questionnaire to survey the range of strategies used for oral anticoagulants reversal in pediatric population. 


If you wish to participate in the questionnaire, please visit the Anticoagulation Reversal in Pediatric Population Survey.

For any questions, please feel free to contact Shveta Gupta


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