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Evaluation of the age-dependent dosing recommendations for the administration of daily tinzaparin in children with thrombosis

Lookup NU author(s): Dr Kate MusgraveORCiD, Kat Webber, Dr Peter Avery, Dr Tina Biss



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley, 2017.

For re-use rights please refer to the publisher's terms and conditions.


BACKGROUND:Recommended starting doses of tinzaparin for the treatment of thrombosis in children have not previously been validated. There are few data to support efficacy and safety of once-daily tinzaparin dosing in children with thrombosis.OBJECTIVES:This study investigated using tinzaparin for the treatment of childhood thrombosis. It aimed to evaluate the age-dependent dosing recommendations and to define outcomes in terms of efficacy and safety.METHODS:This was a retrospective cohort study of children aged 0-<16 years treated for thrombosis at a large teaching hospital in the United Kingdom between 2008 and 2015. Medical records were reviewed to evaluate tinzaparin dosing, anti-factor Xa levels and patient outcomes.RESULTS:79 children were identified to have received tinzaparin. Dosing information was available for 57. Younger children required higher doses to reach a therapeutic level. Therapeutic dose requirement varied within age groups, supporting the use of anti-factor Xa monitoring. Over a median follow up of 35 months, there were 13 (16%) bleeding episodes (2 major; 7 clinically relevant but non-major; 4 minor). There were 2 (3%) recurrent episodes of thrombosis. Children were treated for a median duration of 3 months and the majority (86%) remained on tinzaparin for the duration of their anticoagulant therapy.CONCLUSION:Once-daily tinzaparin is a safe and effective treatment of childhood thrombosis with rates of recurrence and bleeding similar to other anticoagulants used in children. The recommended starting doses are appropriate but anti-factor Xa monitoring may be required due to inter-individual variability in the therapeutic dose requirement. This article is protected by copyright. All rights reserved.

Publication metadata

Author(s): Musgrave KM, Webber K, Murphy P, Avery P, Biss TT

Publication type: Article

Publication status: Published

Journal: Journal of Thrombosis and Haemostasis

Year: 2017

Volume: 15

Issue: 12

Pages: 2361-2366

Print publication date: 01/12/2017

Online publication date: 04/10/2017

Acceptance date: 19/09/2017

Date deposited: 03/11/2017

ISSN (print): 1538-7933

ISSN (electronic): 1538-7836

Publisher: Wiley


DOI: 10.1111/jth.13856

PubMed id: 28976613


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