PB0651 - A Retrospective Study to Evaluate the Reliability of Frequent Mandatory Monitoring of Anti-Xa Level Versus Intermittent Anti-Xa Level in Pediatrics Patients Receiving Enoxaparin, a Multicenter Study

Background: Enoxaparin is widely used for prevention and treatment of thromboembolic disorders. It is an anticoagulant that works by inhibiting Factor Xa. Level monitoring of Anti-Xa activity has been advocated as an essential tool in managing patients receiving enoxaparin.

The main advantages of measuring anti-Xa levels include individualized dosing, reduced risk of bleeding and improved patient outcomes.

Despite the potential benefits of anti-Xa level monitoring, there are challenges associated with its implementation.

Aims: We aim to investigate the utility of anti-Xa level monitoring in enoxaparin by examining its association with clinical outcomes and explore the feasibility of implementing anti-Xa monitoring in clinical practice by comparing daily basis vs intermittent monitoring.

Methods: It is a retrospective descriptive cohort analysis of medical records from patients who received enoxaparin in various clinical settings. This study will include all pediatric population less than 13 years of age with clinical and radiological findings supporting thromboembolic event that was started on enoxaparin from two main hematology centers in Oman with two different approaches (Daily routine and intermittent monitoring).
Chi-square tests will be conducted to determine the significance of any observed differences of both monitoring methods. To identify patient factors influencing anti-Xa levels, multivariable regression analyses will be performed.

Results: This study will compare two different approaches in monitoring anti-Xa level looking into the outcome of resolving thrombus versus adverse effects of Enoxaparin and dose individualization. This flexible approach allows the clinicians to judge the monitoring levels, doses according to the patient’s risk factors. This study can provide a solid baseline to subsequent prospective studies that helps to formulate a clear guideline worldwide.

Conclusion(s): The reliability of frequent mandatory monitoring of anti-Xa levels in patients receiving enoxaparin remains a topic of debate. Collaborative efforts are required to establish guidelines and standardization protocols to enhance the reliability and practicality of this monitoring approach.