Key result
Pharmacokinetic-driven DOAC plans yield 0 bleeding or recurrent thrombosis events in pediatric athletes.
Why the study?
Children on anticoagulation have traditionally been discouraged from contact and collision sports due to perceived bleeding risk, but predictable pharmacokinetics of direct oral anticoagulants permit individualized management.
Does a pharmacokinetic-driven individualized anticoagulation plan prevent clinically significant bleeding or thrombosis in pediatric athletes on direct oral anticoagulants participating in contact or collision sports?
Case Report (n=5)
No
Does a pharmacokinetic-driven individualized anticoagulation plan prevent clinically significant bleeding or thrombosis in pediatric athletes on direct oral anticoagulants participating in contact or collision sports?
Individualized pharmacokinetic-driven anticoagulation plans may allow pediatric athletes on direct oral anticoagulants to safely participate in contact or collision sports without significant bleeding or thrombotic events.
May support individualized DOAC plans in pediatric athletes; hypothesis-generating and requires prospective trials before practice change.
Children on anticoagulation have traditionally been discouraged from participating in contact and collision sports due to a perceived bleeding risk. The predictable pharmacokinetics of direct oral anticoagulants permit more individualized management. At Boston Children's Hospital, pharmacokinetic (PK) data were used to develop individualized anticoagulation plans for five athletes on anticoagulation who wished to participate in contact or collision sports. Median (range) duration of follow-up for the cohort was 27 (1-42) months. During this period, two patients sustained four sports-related injuries during anticoagulation interruption, but no clinically significant bleeding or recurrent/progressive thrombosis was observed. All patients safely resumed anticoagulation post-injury.
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Donnelly et al. (2025) conducted a case report in Pediatric athletes on anticoagulation (n=5). Pharmacokinetic-driven individualized anticoagulation plan (Direct oral anticoagulants) was evaluated on Clinically significant bleeding or recurrent/progressive thrombosis. Pharmacokinetic-driven individualized anticoagulation plans for five pediatric athletes on direct oral anticoagulants resulted in 0 clinically significant bleeding or recurrent thrombosis events.
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