ArticleClinical pharmacokinetics2024
Characterizing Enoxaparin's Population Pharmacokinetics to Guide Dose Individualization in the Pediatric Population.
Article in Clinical pharmacokinetics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Evaluation of Enoxaparin Dosing in Infants Greater Than 2 to 6 Months of Age, a Pre and Post Quasi Experiment.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Optimizing Venous Thromboembolism Prophylaxis in Burn Patients Using Enoxaparin Through PBPK Modeling.CPT: pharmacometrics & systems pharmacology · 2026Article
- Dosing Strategies for High-Alert Medications in Obese Pediatric Patients: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- A real-world data-driven approach to optimizing enoxaparin dosing in burn patients.British journal of clinical pharmacology · 2026Article
- Protein C concentrate pharmacokinetics-no need to fear the curve.Research and practice in thrombosis and haemostasis · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectivePediatric dosing of enoxaparin was derived based on extrapolation of the adult therapeutic range to children. However, a large fraction of children do not achieve therapeutic anticoagulation with initial dosing. We aim to use real-world anti-Xa data obtained from children receiving enoxaparin per standard of care to characterize the population pharmacokinetics (PopPK)
methodsA PopPK analysis was performed using NONMEM, and a stepwise covariate modeling approach was applied for the covariate selection. The final PopPK model, developed with data from 1293 patients ranging in age from 1 day to 18 years, was used to simulate enoxaparin subcutaneous dosing for prophylaxis and treatment based on total body weight (0-18 years, TBW) or fat-free mass (2-18 years, FFM). Simulated exposures in children with obesity (body mass index percentile ≥95th percentile) were compared with those without obesity.
resultsA linear, one-compartment PopPK model that included allometric scaling using TBW (<2 years) or FFM (≥2 years) characterized the enoxaparin pharmacokinetic data. In addition, serum creatinine was identified as a significant covariate influencing clearance. Simulations indicated that in patients aged <2 years, the recommended 1.5 mg/kg TBW-based dosing achieves therapeutic simulated concentrations. In pediatric patients aged ≥2 years, the recommended 1.0 mg/kg dose resulted in exposures more comparable in children with and without obesity when FFM weight-based dosing was applied.
conclusionUsing real-world data and PopPK modeling, enoxaparin's pharmacokinetics were characterized in pediatric patients. Using FFM and twice-daily dosing might reduce the risk of overdosing, especially in children with obesity.
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