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Phlebologie 2026; 55(01): 19-27
DOI: 10.1055/a-2563-8772
Curriculare Fortbildung

Behandlung und Prävention der Venenthrombose in der Pädiatrie

Treatment and Prevention of Venous Thromboembolism in Pediatrics

Authors

  • Christoph Male

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Antikoagulation bei Kindern hat eine Reihe von Herausforderungen. Die direkten oralen Antikoagulanzien (DOAKs) haben für Kinder besonders attraktive Eigenschaften. Infolge systematischer pädiatrischer Studienprogramme erhielten Rivaroxaban, Dabigatran und Apixaban bereits pädiatrische Zulassungen für die Behandlung und Sekundärprävention venöser Thromboembolien (VTE). Dafür wurden kindergerechte Darreichungsformen entwickelt und Dosierungsschemata für die verschiedenen Altersgruppen etabliert.

Abstract

Special aspects of anticoagulation in children include the different epidemiology of thrombosis, developmental changes of the coagulation system, age-dependent pharmacokinetics of anticoagulants, the risk of bleeding, and practical barriers to anticoagulation. The classical anticoagulants pose numerous challenges in children and require regular monitoring. The pharmacological properties of direct oral anticoagulants (DOACs) make them particularly attractive for children. All DOACs underwent pediatric development programs, which investigated treatment of VTEs and, in some cases, various indications for thromboprophylaxis. Child-appropriate dosage forms were developed and dosage regimens for different age groups were established. The efficacy and safety of DOACs in children was comparable to those of standard anticoagulants. Rivaroxaban, dabigatran, and apixaban have already received pediatric authorizations for the treatment of VTEs and prevention of recurrent thrombosis. The studies on primary prophylaxis have all been completed but have not led to pediatric authorizations. Further systematic collection of experience from practical use in children is necessary to validate the data available to date and to expand the evidence base, especially for the youngest age groups and children with specific diseases.

Schlüsselwörter

Kinder - Antikoagulation - Behandlung - Thromboprophylaxe - direkte orale Antikoagulantien

Keywords

children - anticoagulation - treatment - thromboprophylaxis - direct oral anticoagulants


Publication History

Article published online:
12 February 2026

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