{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:05:11Z","timestamp":1753869911935,"version":"3.41.2"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal enoxaparin dosing for treatment of venous thromboembolism (VTE) in pediatric patients with obesity remains uncertain. We described the mean enoxaparin dose required to attain anti\u2010factor Xa (anti\u2010Xa) levels of 0.5\u20131\u00a0unit\/mL in pediatric patients with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pediatric patients with obesity (body mass index [BMI]\u00a0\u226595th percentile) who received treatment dose of enoxaparin from 2013 to 2022 and had at least one appropriately timed anti\u2010Xa level were retrospectively evaluated. Daily enoxaparin dose required to achieve an anti\u2010Xa level of 0.5\u20131\u00a0unit\/mL was reviewed and compared by the severity of obesity. The correlation coefficients between enoxaparin dose requirement and BMI, BMI percentile, and weight were measured by Spearman's rank correlation coefficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pediatric patients with obesity (<jats:italic>n<\/jats:italic>\u00a0=\u00a089) required a mean enoxaparin dose of 0.8\u00a0\u00b1\u00a00.18\u00a0mg\/kg twice daily to attain a therapeutic anti\u2010Xa level. Children with BMI 95th\u201399th percentile and weight \u2264100\u00a0kg achieved the target level on a significantly higher weight\u2010based enoxaparin dose compared to BMI greater than 99th percentile (0.95\u00a0\u00b1\u00a00.15 vs. 0.75\u00a0\u00b1\u00a00.15\u00a0mg\/kg twice daily; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and weight greater than 100\u00a0kg (0.95\u00a0\u00b1\u00a00.14 vs. 0.7\u00a0\u00b1\u00a00.12\u00a0mg\/kg twice daily; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). BMI, BMI percentile, and weight showed a moderate to strong negative correlation with enoxaparin dose requirement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pediatric patients with obesity required a lower weight\u2010based dose of enoxaparin to achieve a therapeutic anti\u2010Xa than the recommended starting dose of 1\u00a0mg\/kg twice daily for treatment of VTE. Among obesity indices, weight showed the strongest negative correlation with total daily enoxaparin requirement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31033","type":"journal-article","created":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T06:25:19Z","timestamp":1714803919000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enoxaparin treatment dosing for venous thromboembolism in pediatric patients with obesity"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6653-2868","authenticated-orcid":false,"given":"Juwon","family":"Yim","sequence":"first","affiliation":[{"name":"Department of Pharmacy Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afrin","family":"Jahan","sequence":"additional","affiliation":[{"name":"Advanced Analytics and Outcomes Team Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolay","family":"Braykov","sequence":"additional","affiliation":[{"name":"Advanced Analytics and Outcomes Team Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-0974","authenticated-orcid":false,"given":"Gary M.","family":"Woods","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1001\/jamapediatrics.2022.2052"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1016\/j.thromres.2018.07.016"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.3109\/08880018.2014.886315"},{"issue":"5","key":"e_1_2_8_5_1","first-page":"26","article-title":"Treatment of venous thromboembolism in pediatric patients","volume":"28","author":"Malec L","year":"2017","journal-title":"Front Pediatr"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1177\/1076029614568713"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1007\/s11239-014-1117-y"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1177\/1060028018768449"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.18773\/austprescr.2017.053"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1016\/j.clinthera.2015.05.495"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1016\/j.jtha.2023.03.004"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1542\/peds.2007-2329C"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1378\/chest.119.1_suppl.344S"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1038\/sj.clpt.6100381"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1177\/1060028017734234"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1007\/s40262-015-0277-z"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1111\/bcp.15459"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1002\/rth2.12032"},{"doi-asserted-by":"publisher","key":"e_1_2_8_19_1","DOI":"10.1016\/j.jpeds.2012.07.047"},{"doi-asserted-by":"publisher","key":"e_1_2_8_20_1","DOI":"10.1002\/cpt.2618"},{"doi-asserted-by":"publisher","key":"e_1_2_8_21_1","DOI":"10.1097\/FTD.0b013e3181e64846"},{"doi-asserted-by":"publisher","key":"e_1_2_8_22_1","DOI":"10.1111\/j.1365-2141.2010.08163.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_23_1","DOI":"10.1160\/TH08-03-0148"}],"container-title":["Pediatric Blood &amp; 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