Factor XI Inhibitors in Atrial Fibrillation: Insights and Implications from Recent Trials - PubMed
5 hours ago
- #Atrial Fibrillation
- #Anticoagulation
- #Stroke Prevention
- Stroke prevention is crucial in atrial fibrillation (AF) management due to increased thromboembolic risk.
- Direct oral anticoagulants (DOACs) improve stroke prophylaxis but have bleeding risks and are underused.
- Factor XI (FXI) inhibitors are emerging as alternatives with potential for reduced bleeding risks.
- Different FXI inhibitors under development include small molecules, monoclonal antibodies, and antisense oligonucleotides.
- Early trials show favorable safety profiles for FXI inhibitors compared to DOACs.
- Abelacimab, an anti-FXI monoclonal antibody, showed lower bleeding rates than rivaroxaban in AF patients.
- The OCEANIC-AF trial was terminated early due to lack of efficacy with asundexian, raising concerns.
- Phase 3 trials are ongoing to determine the true efficacy of FXI inhibitors.
- This review discusses the advantages, challenges, and future applications of FXI inhibitors in AF.