» Articles » PMID: 38862574

Efficacy and Safety of Antithrombotic Therapy for Preventing and Treating Pediatric Thromboembolic Disease: a Systematic Review

Overview
Journal Sci Rep
Specialty Science
Date 2024 Jun 11
PMID 38862574
Authors
Affiliations
Soon will be listed here.
Abstract

This review used traditional and network meta-analyses (NMA) to conduct a comprehensive study of antithrombotic therapies in children with thromboembolic disease. We searched the PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov databases from their inception to 26 February, 2023. And we finally included 16 randomized controlled trials. In the prevention of thromboembolic events (TEs), the use of anticoagulants had a low risk of TEs (relative risk (RR) 0.73, 95% CI 0.56 to 0.94) and a high risk of minor bleeding (RR 1.43, 95% CI 1.09 to 1.86) compared with no anticoagulants. In the treatment of TEs, direct oral anticoagulants (DOACs) were not inferior to standard anticoagulation in terms of efficacy and safety outcomes. In NMA, rivaroxaban and apixaban showed the lowest risk for TEs and major or clinically relevant nonmajor bleeding. According to the overall assessment of efficacy and safety, dabigatran may be the best choice for children with thromboembolic disease. The results of our study will provide references and suggestions for clinical drug selection.

References
1.
Li A, Garcia D, Lyman G, Carrier M . Direct oral anticoagulant (DOAC) versus low-molecular-weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): A systematic review and meta-analysis. Thromb Res. 2018; 173:158-163. PMC: 6119655. DOI: 10.1016/j.thromres.2018.02.144. View

2.
Pessotti C, Jatene M, Jatene I, Oliveira P, Succi F, Moreira V . Comparative trial of the use of antiplatelet and oral anticoagulant in thrombosis prophylaxis in patients undergoing total cavopulmonary operation with extracardiac conduit: echocardiographic, tomographic, scintigraphic, clinical and laboratory.... Rev Bras Cir Cardiovasc. 2015; 29(4):595-605. PMC: 4408824. DOI: 10.5935/1678-9741.20140111. View

3.
Kahan B, Harhay M . Many multicenter trials had few events per center, requiring analysis via random-effects models or GEEs. J Clin Epidemiol. 2015; 68(12):1504-11. PMC: 4845666. DOI: 10.1016/j.jclinepi.2015.03.016. View

4.
Hutton B, Salanti G, Caldwell D, Chaimani A, Schmid C, Cameron C . The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015; 162(11):777-84. DOI: 10.7326/M14-2385. View

5.
Ruud E, Holmstrom H, de Lange C, Hogstad E, Wesenberg F . Low-dose warfarin for the prevention of central line-associated thromboses in children with malignancies--a randomized, controlled study. Acta Paediatr. 2006; 95(9):1053-9. DOI: 10.1080/08035250600729092. View