An international research team led by MedUni Vienna has confirmed the long-term safety and effectiveness of rivaroxaban for extended use in children with venous thromboembolism (VTE), according to findings published in The Lancet Haematology.
The study, led by Christoph Male from the Department of Pediatrics and Adolescent Medicine at MedUni Vienna, provides the first reliable evidence for extended anticoagulation in pediatric patients. Researchers assessed approximately 500 children and adolescents from the EINSTEIN Jr study for extended treatment periods of up to one year.
"Our EINSTEIN Jr. study and the long-term investigation now available show that rivaroxaban is an effective and safe option for preventing recurrent thrombosis in children, not only during acute treatment but also extended treatment," said study leader Christoph Male.
Addressing a Critical Gap in Pediatric Thrombosis Treatment
Venous thromboembolism occurs when blood clots form in deep veins, causing local vessel obstruction or embolization to the lungs—a potentially life-threatening condition. While VTE has been extensively researched in adults, there has long been a lack of solid clinical data for children.
Until recently, anticoagulant treatment for children relied on the off-label use of medications developed for adults, such as heparin or vitamin K antagonists. These treatments present significant challenges for pediatric patients, including administration by injection and the requirement for regular blood monitoring.
The 2020 EINSTEIN Jr study, also led by MedUni Vienna, demonstrated that rivaroxaban was at least as effective and safe as standard anticoagulants for children with VTE. These positive results led to the worldwide approval of rivaroxaban for pediatric use in 2021.
Long-Term Safety Profile Established
The newly published long-term data addresses a critical research gap regarding extended anticoagulation in children with VTE. The findings reveal that even with treatment durations of up to one year, there is only a low risk of VTE recurrence and serious bleeding complications.
This research establishes rivaroxaban as the first scientifically proven age-appropriate alternative to standard anticoagulation therapies for children. The significance of this advancement is further highlighted in an accompanying editorial in The Lancet Haematology.
Advantages for Young Patients
Direct oral anticoagulants like rivaroxaban offer several practical advantages that are particularly beneficial for pediatric patients. Unlike traditional therapies, rivaroxaban:
- Can be administered orally rather than by injection
- Eliminates the need for regular blood tests
- Has been specifically adapted for children in recent years
- Provides consistent dosing with predictable effects
These benefits represent a significant improvement in the management of VTE in children, particularly those with serious underlying conditions such as heart defects or cancer, where thrombosis treatment poses additional clinical challenges.
The study's findings provide clinicians with valuable evidence to support extended anticoagulation therapy decisions for pediatric patients, potentially improving treatment adherence and quality of life for young patients requiring long-term anticoagulation.
