Danny Hsu: Unlocking The Real-World Potential of DOACs in Paediatric Thrombosis
Danny Hsu, President of THANZ, Director of Therapeutic Apheresis, Immune and Obstetric Haematology at South Western Sydney Local Health District, shared a post on LinkedIn about a recent article by C.A. Brown et al. published in Thrombosis Research, adding:
“Unlocking the real-world potential of DOACs in Paediatric Thrombosis!
I am absolutely thrilled to spotlight incredible local research that is directly improving the lives of our youngest patients.
A fantastic new paper out of Sydney Children’s Hospital has just provided us with vital, real-world data on Direct Oral Anticoagulant (DOAC) use in children.
Historically, anticoagulation in paediatrics meant frequent injections or invasive monitoring – a massive burden on kids and their families.
This retrospective study analyzed 67 paediatric patients (representing 74 treatment episodes) who were prescribed a DOAC between January 2021 and May 2025.
Here are the standout findings that we should all be celebrating:
- Highly Effective: The study demonstrated a massive 95% treatment success rate across a wide range of indications, including therapeutic and prophylactic use. Crucially, there were zero fatal venous thromboembolism (VTE) events.
- Excellent Safety Profile: Reassuringly, there were absolutely zero major bleeding events recorded. The rate of clinically relevant non-major bleeding was only 4%. Notably, all of these events were heavy menstrual bleeding, highlighting the need for tailored counseling for adolescent females.
- Quality of Life Wins: Perhaps the best part of this real-world data is seeing kids be kids! Five patients safely omitted a single weekly DOAC dose to allow them to participate in organized contact sports. Not a single one of these patients experienced a recurrent or new clot.
This data is a huge step forward in confirming the effectiveness and safety of DOACs for paediatric thromboembolism.
A massive congratulations to the authors for building this essential evidence base!
Are you currently integrating DOACs into your paediatric practice?
I’d love to hear your thoughts on this study below!”
Title: Real world experience of direct oral anticoagulant (DOAC) use in Australian children
Authors: C.A. Browna, M. Jackson, P. Monagle, S. Russell, M. Wiggins

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