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Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review

ESSENTIALS: Data is scarce on enoxaparin dosing for obese adolescents with venous thromboembolism (VTE). Overweight and obese adolescents treated with reduced enoxaparin dose (RD) were reviewed. Initial enoxaparin doses calculated using actual body weight may be greater than what is needed. Trials a...

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Autores principales: Hoffman, Stephanie, Braunreiter, Chi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6058273/
https://www.ncbi.nlm.nih.gov/pubmed/30046689
http://dx.doi.org/10.1002/rth2.12032
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author Hoffman, Stephanie
Braunreiter, Chi
author_facet Hoffman, Stephanie
Braunreiter, Chi
author_sort Hoffman, Stephanie
collection PubMed
description ESSENTIALS: Data is scarce on enoxaparin dosing for obese adolescents with venous thromboembolism (VTE). Overweight and obese adolescents treated with reduced enoxaparin dose (RD) were reviewed. Initial enoxaparin doses calculated using actual body weight may be greater than what is needed. Trials are warranted to evaluate RD enoxaparin for overweight and obese adolescents with VTE. BACKGROUND: The global obesity epidemic has created new challenges, including venous thromboembolisms (VTE) in obese adolescents. The data on whether to reduce the dose of low‐molecular heparin in obese adults is conflicting, and information on adolescent patients is scarce. OBJECTIVES: Our primary goal was to describe dosing, anti‐Xa levels, and outcomes of overweight and obese adolescents who received reduced doses of enoxaparin at the initiation of therapy. The secondary goal was to compare their outcomes to overweight and obese adolescents who received standard 1 mg/kg dosing to determine if future trials for dose reduction are warranted. PATIENTS/METHODS: We performed a retrospective cohort study of overweight and obese patients between the ages of 12 and 18 years old diagnosed with VTE who were treated with reduced dosing (RD) of enoxaparin, comparing their dosing, anti‐Xa levels, and outcomes to overweight and obese adolescents who received standard dosing (SD). RESULTS: RD patients (n=19) achieved therapeutic mean initial anti‐Xa levels that were similar to SD patients (n=11). Of the RD patients, 53% did not require dose adjustments during treatment. Two RD patients had thrombus progression. A total of 25 patients ultimately completed therapy with RD. CONCLUSIONS: Future trials are warranted to evaluate the efficacy and safety of reduced dosing of enoxaparin to treat overweight and obese adolescents with VTE.
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spelling pubmed-60582732018-07-25 Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review Hoffman, Stephanie Braunreiter, Chi Res Pract Thromb Haemost Original Articles: Thrombosis ESSENTIALS: Data is scarce on enoxaparin dosing for obese adolescents with venous thromboembolism (VTE). Overweight and obese adolescents treated with reduced enoxaparin dose (RD) were reviewed. Initial enoxaparin doses calculated using actual body weight may be greater than what is needed. Trials are warranted to evaluate RD enoxaparin for overweight and obese adolescents with VTE. BACKGROUND: The global obesity epidemic has created new challenges, including venous thromboembolisms (VTE) in obese adolescents. The data on whether to reduce the dose of low‐molecular heparin in obese adults is conflicting, and information on adolescent patients is scarce. OBJECTIVES: Our primary goal was to describe dosing, anti‐Xa levels, and outcomes of overweight and obese adolescents who received reduced doses of enoxaparin at the initiation of therapy. The secondary goal was to compare their outcomes to overweight and obese adolescents who received standard 1 mg/kg dosing to determine if future trials for dose reduction are warranted. PATIENTS/METHODS: We performed a retrospective cohort study of overweight and obese patients between the ages of 12 and 18 years old diagnosed with VTE who were treated with reduced dosing (RD) of enoxaparin, comparing their dosing, anti‐Xa levels, and outcomes to overweight and obese adolescents who received standard dosing (SD). RESULTS: RD patients (n=19) achieved therapeutic mean initial anti‐Xa levels that were similar to SD patients (n=11). Of the RD patients, 53% did not require dose adjustments during treatment. Two RD patients had thrombus progression. A total of 25 patients ultimately completed therapy with RD. CONCLUSIONS: Future trials are warranted to evaluate the efficacy and safety of reduced dosing of enoxaparin to treat overweight and obese adolescents with VTE. John Wiley and Sons Inc. 2017-08-10 /pmc/articles/PMC6058273/ /pubmed/30046689 http://dx.doi.org/10.1002/rth2.12032 Text en © 2017 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and Haemostasis. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles: Thrombosis
Hoffman, Stephanie
Braunreiter, Chi
Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title_full Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title_fullStr Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title_full_unstemmed Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title_short Reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
title_sort reduced dosing of enoxaparin for venous thromboembolism in overweight and obese adolescents: a single institution retrospective review
topic Original Articles: Thrombosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6058273/
https://www.ncbi.nlm.nih.gov/pubmed/30046689
http://dx.doi.org/10.1002/rth2.12032
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