Show simple item record

dc.contributor.authorThom, K
dc.contributor.authorLensing, AWA
dc.contributor.authorNurmeev, I
dc.contributor.authorBajolle, F
dc.contributor.authorBonnet, D
dc.contributor.authorKenet, G
dc.contributor.authorMassicotte, MP
dc.contributor.authorKarakas, Z
dc.contributor.authorPalumbo, JS
dc.contributor.authorSaracco, P
dc.contributor.authorAmedro, P
dc.contributor.authorChain, J
dc.contributor.authorChan, AK
dc.contributor.authorIkeyama, T
dc.contributor.authorLam, JCM
dc.contributor.authorGauger, C
dc.contributor.authorPap, AF
dc.contributor.authorMajumder, M
dc.contributor.authorKubitza, D
dc.contributor.authorSmith, WT
dc.contributor.authorBerkowitz, SD
dc.contributor.authorPrins, MH
dc.contributor.authorMonagle, P
dc.contributor.authorYoung, G
dc.contributor.authorMale, C
dc.date.accessioned2020-12-14T06:37:10Z
dc.date.available2020-12-14T06:37:10Z
dc.date.issued2020-10-13
dc.identifierpii: S2473-9529(20)31196-4
dc.identifier.citationThom, K., Lensing, A. W. A., Nurmeev, I., Bajolle, F., Bonnet, D., Kenet, G., Massicotte, M. P., Karakas, Z., Palumbo, J. S., Saracco, P., Amedro, P., Chain, J., Chan, A. K., Ikeyama, T., Lam, J. C. M., Gauger, C., Pap, A. F., Majumder, M., Kubitza, D. ,... Male, C. (2020). Safety and efficacy of anticoagulant therapy in pediatric catheter-related venous thrombosis (EINSTEIN-Jr CVC-VTE). BLOOD ADVANCES, 4 (19), pp.4632-4639. https://doi.org/10.1182/bloodadvances.2020002637.
dc.identifier.issn2473-9529
dc.identifier.urihttp://hdl.handle.net/11343/254277
dc.description.abstractAnticoagulant treatment of pediatric central venous catheter-related venous thromboembolism (CVC-VTE) has not been specifically evaluated. In EINSTEIN-Jr, 500 children with any VTE received rivaroxaban or standard anticoagulants. A predefined analysis of the CVC-VTE cohort was performed. Children with CVC-VTE (age, birth to 17 years) were administered rivaroxaban or standard anticoagulants during the 1-month (children <2 years) or 3-month (all other children) study period. Predefined outcomes were recurrent VTE, change in thrombotic burden on repeat imaging, and bleeding. Predictors for continuation of anticoagulant therapy beyond the study period were evaluated. One hundred twenty-six children with symptomatic (n = 76, 60%) or asymptomatic (n = 50, 40%) CVC-VTE received either rivaroxaban (n = 90) or standard anticoagulants (n = 36). There was no recurrent VTE (0%; 95% confidence interval [CI], 0.0%-2.8%). Three children had the principal safety outcome: none had major bleeding and 3 children had clinically relevant nonmajor bleeding (2.4%; 95% CI, 0.7%-6.5%), all in the rivaroxaban arm. Complete or partial vein recanalization occurred in 57 (55%) and 38 (37%) of 103 evaluable children, respectively. Results were similar for symptomatic and asymptomatic CVC-VTE. Continuation of anticoagulant therapy beyond the study period occurred in 61 (48%) of children and was associated with residual VTE but only in children <2 years (odds ratio [OR], 20.9; P = .003) and continued CVC use (OR, 6.7; P = .002). Anticoagulant therapy appeared safe and efficacious and was associated with reduced clot burden in most children with symptomatic or asymptomatic CVC-VTE. Residual VTE and continued CVC use were associated with extended anticoagulation. This trial was registered at www.clinicaltrials.gov as #NCT02234843.
dc.languageEnglish
dc.publisherAMER SOC HEMATOLOGY
dc.titleSafety and efficacy of anticoagulant therapy in pediatric catheter-related venous thrombosis (EINSTEIN-Jr CVC-VTE)
dc.typeJournal Article
dc.identifier.doi10.1182/bloodadvances.2020002637
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.source.titleBlood Advances
melbourne.source.volume4
melbourne.source.issue19
melbourne.source.pages4632-4639
melbourne.elementsid1469138
melbourne.openaccess.urlhttp://doi.org/10.1182/bloodadvances.2020002637
melbourne.openaccess.statusPublished version
melbourne.contributor.authorMonagle, Paul
dc.identifier.eissn2473-9537
melbourne.accessrightsAccess this item via the Open Access location


Files in this item

FilesSizeFormatView

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record