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FondaKIDS III: A long‐term retrospective cohort study of fondaparinux for treatment of venous thromboembolism in children
Author(s) -
Shen Xiaofan,
Wile Rachel,
Young Guy
Publication year - 2020
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.28295
Subject(s) - fondaparinux , medicine , dosing , retrospective cohort study , incidence (geometry) , venous thromboembolism , cohort , surgery , pediatrics , thrombosis , physics , optics
Background The incidence of venous thromboembolism (VTE) and use of anticoagulation are rising in children, but treatment options remain limited. As a newer anticoagulant, fondaparinux may be a safe and effective alternative with the benefit of once‐daily dosing, but there is relatively little data supporting its use. Procedure This retrospective cohort study describes the long‐term dosing, efficacy, and safety of fondaparinux for treatment of VTE in children at a single institution. The study included children <18 years old treated with fondaparinux for VTE between 2008 and 2018. Descriptive statistics were used to present the findings. Results A total of 277 patients were identified and analyzed in this study. Seventy‐six percent of patients reached therapeutic levels with 0 or 1 dose adjustments over a median treatment duration of 93 days. Of the patients included in the efficacy analysis, 91% of patients had improvement in their clot status, including 69% (160/233) with complete resolution and 22% (53/233) with partial resolution. Twenty‐six patients (11%) had VTE recurrence, but only seven (3%) of the new thrombi developed while on fondaparinux. Major bleeding occurred in seven patients (2.5%), primarily in patients with underlying medical conditions with increased bleeding risk. Minor bleeding occurred in 53 patients (19%). Conclusions This study demonstrates the stable long‐term pediatric dosing of fondaparinux with similar efficacy and safety when compared to other anticoagulants. Given its advantages, fondaparinux can be considered a reasonable alternative for treatment of VTE in children.