The value of the old and the new

Article Medicine, General & Internal

Effect of Anticoagulant Therapy for 6 Weeks vs 3 Months on Recurrence and Bleeding Events in Patients Younger Than 21 Years of Age With Provoked Venous Thromboembolism The Kids-DOTT Randomized Clinical Trial

Neil A. Goldenberg et al.

Summary: Among patients younger than 21 years of age with provoked venous thromboembolism, 6-week anticoagulant therapy was noninferior to 3-month therapy in terms of recurrent venous thromboembolism risk and bleeding risk.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

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Article Hematology

Symptomatic pulmonary embolus after catheter removal in children with catheter related thrombosis: A report from the CHAT Consortium

Julie Jaffray et al.

Summary: This retrospective cohort study evaluated the incidence of symptomatic pulmonary embolism (PE) after central venous catheter (CVC) removal in children.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2022)

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Review Critical Care Medicine

Acute Management of High-Risk and Intermediate-Risk Pulmonary Embolism in Children A Review

Catherine Ross et al.

Summary: Severe forms of pulmonary embolism (PE) in children can lead to significant morbidity and mortality. This review proposes pediatric-specific risk stratifications and an acute treatment algorithm to guide emergent decision-making. Rapid primary reperfusion should be pursued for high-risk PE, while the decision to pursue primary reperfusion in intermediate-risk PE is complex and depends on patient severity. Various treatment options including systemic thrombolysis, surgical embolectomy, catheter-based therapies, and anticoagulation alone may be considered for acute management of severe PE in children.

CHEST (2022)

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Article Pharmacology & Pharmacy

Dosing Regimen Prediction and Confirmation With Rivaroxaban for Thromboprophylaxis in Children After the Fontan Procedure: Insights From the Phase III UNIVERSE Study

Peijuan Zhu et al.

Summary: Thrombosis is a common complication following the Fontan procedure for children with single-ventricle physiology. The use of rivaroxaban as a thromboprophylaxis is supported by a model-informed drug development approach, which determined a pediatric dosing regimen based on predicted drug exposures similar to that of adults. The UNIVERSE study confirmed the appropriateness of the body weight-based dosing regimen for thromboprophylaxis in post-Fontan pediatric patients aged 2 to 8 years.

JOURNAL OF CLINICAL PHARMACOLOGY (2022)

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Article Clinical Neurology

Anticoagulant Treatment for Pediatric Infection-Related Cerebral Venous Thrombosis

Mayte Sanchez van Kammen et al.

Summary: This study aimed to explore the clinical characteristics and outcomes of children with cerebral venous thrombosis (CVT) and a head or neck infection who received therapeutic anticoagulants. The results showed that these children generally had low risks of bleeding and thrombotic complications, including those who underwent surgical interventions with delay or interruption of anticoagulation.

PEDIATRIC NEUROLOGY (2022)

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Article Hematology

Anticoagulant Effects of Dabigatran on Coagulation Laboratory Parameters in Pediatric Patients: Combined Data from Five Pediatric Clinical Trials

Lesley G. Mitchell et al.

THROMBOSIS AND HAEMOSTASIS (2022)

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Article Cardiac & Cardiovascular Systems

Edoxaban for Thromboembolism Prevention in Pediatric Patients With Cardiac Disease

Michael A. Portman et al.

Summary: This study aimed to evaluate the safety and efficacy of edoxaban in children. The results showed that edoxaban is a potential alternative for thromboprophylaxis in children with cardiac disease, with low rates of bleeding and thrombotic events.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2022)

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Article Hematology

Dabigatran in the treatment and secondary prophylaxis of venous thromboembolism in children with thrombophilia

Leonardo R. Brandao et al.

Summary: In the DIVERSITY trial, dabigatran treatment for 3 months was found to be as effective as standard of care for acute venous thromboembolism in children, and up to 12 months of dabigatran use showed favorable safety in a secondary prevention study. This suggests that dabigatran could be a suitable long-term anticoagulant for children with thrombophilia.

BLOOD ADVANCES (2022)

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Article Hematology

Anticoagulation in pediatric cancer-associated venous thromboembolism: a subgroup analysis of EINSTEIN-Jr

Joseph S. Palumbo et al.

Summary: Anticoagulant treatments for pediatric cancer-associated venous thromboembolism (VTE) have not been prospectively evaluated. Both rivaroxaban and standard anticoagulants appear safe and effective for most children with cancer-associated VTE, even with treatment interruptions. Rivaroxaban exposures are similar to those of adults and children without cancer-associated VTE.

BLOOD ADVANCES (2022)

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Article Hematology

Dabigatran etexilate for the treatment of acute venous thromboembolism in children (DIVERSITY): a randomised, controlled, open-label, phase 2b/3, non-inferiority trial

Jacqueline Halton et al.

Summary: The study found that an age-adjusted and weight-adjusted dosing algorithm for dabigatran was effective in children with venous thromboembolism, showing similar pharmacokinetic-pharmacodynamic relationships to those seen in adults. In terms of efficacy, dabigatran was non-inferior to standard of care, indicating it may be a suitable alternative treatment option.

LANCET HAEMATOLOGY (2021)

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Article Health Care Sciences & Services

GRADE notes: How to use GRADE when there is no evidence? A case study of the expert evidence approach

Reem A. Mustafa et al.

Summary: This article presents a method of developing evidence-based recommendations using expert evidence survey when direct published evidence is lacking. In many clinical questions, published evidence may be limited, so transparently dealing with the lack of direct evidence is crucial.

JOURNAL OF CLINICAL EPIDEMIOLOGY (2021)

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Article Hematology

Pharmacokinetic modeling and simulation support for age- and weight-adjusted dosing of dabigatran etexilate in children with venous thromboembolism

Daniel Roshammar et al.

Summary: This study evaluated DE pharmacokinetics in children with VTE using a population PK model, and confirmed that the final pediatric dosing algorithms were appropriate for all DE formulations without the need for dose adjustment.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2021)

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Article Cardiac & Cardiovascular Systems

Thromboprophylaxis for Children Post-Fontan Procedure: Insights From the UNIVERSE Study

Brian W. McCrindle et al.

Summary: The UNIVERSE Study evaluated the efficacy and safety of liquid rivaroxaban versus acetylsalicylic acid in preventing thrombotic events in patients with single-ventricle physiology post-Fontan. The study found that participants receiving rivaroxaban had a better safety profile and fewer thrombotic events compared to those in the ASA group, although the difference was not statistically significant.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2021)

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Article Hematology

How to write a guideline: a proposal for a manuscript template that supports the creation of trustworthy guidelines

Robby Nieuwlaat et al.

Summary: The study aimed to develop a detailed template for transparent and complete reporting of guidelines, including title, abstract, overview of all recommendations, and main text. Initial experience with the ASH guideline manuscript template was positive, but challenges included drafting descriptions of recommendations involving multiple management pathways, tailoring the template for a specific guideline, and choosing key recommendations to highlight.

BLOOD ADVANCES (2021)

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Article Hematology