Targeting factor XI as a compromise between thrombosis and bleeding

Thromboembolic diseases have long been a leading cause of morbidity and mortality, necessitating advances in anticoagulant drugs. Heparins, vitamin K inhibitors, and direct oral anticoagulants (DOACs) are well-established drug classes that help prevent thromboembolic complications. While effective, they pose significant risks during long-term therapy, including bleeding, osteoporosis, heparin-induced thrombocytopenia, and the need for frequent monitoring and dose adjustments. Factor XI (FXI) inhibitors represent an innovative approach in anticoagulation therapy, aiming to balance thromboembolic events with the risk of bleeding complications. They include: a) orally administered small molecule inhibitors such as milvexian and asundexian; b) monoclonal antibodies such as abelacimab, osocimab, and xisomab, which specifically bind and inactivate FXI; c) FXI-antisense oligonucleotide (FXI-ASO), which downregulate FXI synthesis at the mRNA level and reduce plasma FXI concentrations. Available data indicate that FXI inhibitors decrease the risk of thromboembolic events and are associated with a lower incidence of major bleeding than current gold standard methods. Hence, FXI inhibitors may become the preferred anticoagulant class, especially for patients with elevated bleeding risk. Their development is an important step in the history of anticoagulant therapy, striving to find a balance between preventing thromboembolism and reducing bleeding risk, ultimately improving patient outcomes. In this context, a discussion on the characteristics of FXI inhibitors, a summary on data regarding the efficacy and safety of FXI inhibitors based on preclinical and clinical studies, and an outline of future perspectives regarding therapeutic strategies of FXI inhibition in venous thrombosis are presented in this study.

Abstract aus PubMed (NCBI) für den zitierten Eintrag, in der Originalsprache wiedergegeben. Maßgeblich ist die Fassung der Originalpublikation.

Das Abstract wird nicht übersetzt, damit die eigene Wortwahl der Autoren erhalten bleibt.

This review examines factor XI inhibitors as a new anticoagulant class, covering oral small molecules (milvexian, asundexian), monoclonal antibodies (abelacimab), and antisense oligonucleotides. Available data suggest reduced thromboembolic events with less major bleeding than current standard therapy.

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

Weitere begutachtete Studien in der Kategorie „Sicherheit & Infektionskontrolle“.

• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Auswirkungen der Hirudotherapie auf Leberfunktionen, Lipidprofil und Insulinsensitivität bei Ratten mit metabolischem Syndrom — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Improvement of patient care through hirudotherapy and the management of leeches from their reception to their disposal in France — Vaesken C et al. (2023)
• Hirudotherapy in Medicine and Dentistry — Jha K et al. (2015)
• Management of Chronic Non-healing Wounds by Hirudotherapy — Iqbal A et al. (2017)
• Hirudotherapie lindert arthritische Schmerzen bei Patienten mit verschiedenen chronischen Schmerzsyndromen: eine retrospektive Analyse — Loeser J et al. (2020)
• Hirudotherapy (medicinal leeches) for treatment of upper airway obstruction in a dog — Trenholme H, Masseau I, Reinero C (2021)
• Analyse antibiotikaresistenter Infektionen im Zusammenhang mit Hirudotherapie — Brauer P et al. (2024)
• Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy — Curcio J, Lloyd C (2020)

Alle von der ASH analysierten Studien →