Antithrombotic Therapy in Children: Clinical Trials Currently Being Conducted
Clinical Trials Currently Being Conducted
In general, the levels of evidence supporting guidelines for anticoagulation in children are suboptimal. The reduced incidence of thromboembolic disease in children compared to adults limits the value of single institution studies. The rapid emergence of thromboembolic complications as a major problem in tertiary pediatric health care over the last decade has led to the development of collaborative clinical trial groups. Current and future multicenter trials will provide the best evidence from which to formulate specific guidelines for the management of thromboembolic disease in children.
There are currently five ongoing multicenter, multinational, randomized, controlled trials assessing the optimal use of anticoagulants in children with or at risk for specific thromboembolic complications. The following section briefly describes these trials fully asthma medications inhalers.
REVIVE: This study (Reviparin in Venous ThromboEmbolism) is a randomized, controlled trial comparing LMWH (Reviparin) to standard heparin and warfarin for the treatment of DVT in children.
PROTEKT: This study (Prophylaxis of ThromboEmbolism in Kids Trial) is a randomized, controlled trial comparing LMWH (Reviparin) to standard of care primary prophylaxis for the prevention of DVT in children with CVLs.
FONTAN A: This is a randomized, controlled trial comparing aspirin to heparin/warfarin as primary prophylaxis against thromboembolic complications following Fontan surgery.
SLE study: This study is a randomized, placebo-controlled trial of warfarin anticoagulation (INR 2.0 to 2.5) for primary thromboembolic prophylaxis in children with systemic lupus erythematosus and antiphospholipid antibodies.
PARKAA: This study (Prophylactic Antithrombin Replacement in Kids with Acute lymphoblastic leukaemia treated with Asparaginase) is a randomized controlled trial of AT replacement as thromboembolic prophylaxis for children with acute lymphoblastic leukaemia during L-asparaginase therapy.