Abstract Number: PB0797
Meeting: ISTH 2021 Congress
Background: Once a day enoxaparin (ODE) is considered standard of care (SOC) for venous thromboembolism (VTE) in adults, with few pediatric studies showing variable clinical results. We sought to review our center’s experience with ODE in treating pediatric VTE and to compare its efficacy with twice a day enoxaparin (TDE), considered SOC.
Aims: To compare efficacy of ODE to TDE in pediatric VTE.
Methods: A retrospective chart review of children with VTE treated with ODE or TDE from 2016-2021 was undertaken, with IRB approval and waiver of consent. Data about patient demographics, VTE, treatment and complications were collected.
Results: Seventy-one children with VTE met the eligibility criteria; 39 (55%; median age 0.99 yrs; range 0-17; 44% F) were treated with ODE (median dose 1.5 mg/kg; IQR 1.2-2.0) and 32 (44%; median age 0.46 yrs; range 0-17; 38% F) were treated with TDE (median dose 1.1 mg/kg; IQR 1.0-1.4). ODE patients were initially treated with TDE (median 14 d; IQR 10-14), before switching to ODE. Most common site of VTE was extremity, more common in ODE than TDE (ODE N=21, 54% vs. TDE N=16, 23%, p=0.033) and most common risk factor was central line (ODE N=29, 74% vs. TDE N=19, 60%) for both cohorts. There was no statistically significant difference in the total duration of therapy (>3 mo; ODE 95%, TDE 91%; p=0.276). Bleeding complications were rare (ODE: N=2, 5%; TDE N=5, 15.6%; p=0.231). ODE and TDE had no difference in outcome (p=1.000), with all patients having resolved, improved, or stable VTE.
Conclusions: ODE for pediatric VTE therapy appears to be equally efficacious as TDE, with 100% achieving favorable outcome in both cohorts. Less frequent injections with ODE may also potentially improve patient adherence. Larger randomized trials between ODE and TDE will help validate our center’s observation.
To cite this abstract in AMA style:Montanez N, Gibson A, Addy K, Hashmi SS, Brown D, Rodriguez N, Menon N, Srivaths L. Once a Day Compared to Twice a Day Enoxaparin in Children with Venous Thromboembolism: A Single Center Experience [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/once-a-day-compared-to-twice-a-day-enoxaparin-in-children-with-venous-thromboembolism-a-single-center-experience/. Accessed December 3, 2021.
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