A proposal for managing bleeding in patients on therapeutic factor XI(a) inhibitors.
anticoagulants
factor XI
factor XIa
hemostasis
thrombosis
Journal
Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
27
10
2021
received:
23
09
2021
accepted:
01
11
2021
pubmed:
5
11
2021
medline:
11
3
2022
entrez:
4
11
2021
Statut:
ppublish
Résumé
Several drugs that reduce functional levels of the plasma protease zymogen factor XI (FXI), or that inhibit its activated form (FXIa), are being evaluated as treatments to prevent thrombosis. Based on the observation that individuals with inherited FXI deficiency have a relatively mild bleeding disorder, it is anticipated that therapeutic FXI(a) inhibitors will have a smaller impact on hemostasis than anticoagulants targeting thrombin or factor Xa. However, even if FXI(a) inhibitors are determined to be safer than currently used anticoagulants, some patients on these drugs will experience abnormal bleeding or require emergent surgery. Strategies for dealing with such situations are required. Treatment with antifibrinolytic agents and low doses of recombinant factor VIIa effectively prevent abnormal bleeding in FXI-deficient patients with alloantibody inhibitors to FXI who undergo surgery. We propose that a similar strategy can be used for patients on therapeutic FXI(a) inhibitors who are bleeding or require invasive procedures.
Identifiants
pubmed: 34735741
doi: 10.1111/jth.15579
pmc: PMC9540351
mid: NIHMS1840389
pii: S1538-7836(22)02749-0
doi:
Substances chimiques
Factor XI
9013-55-2
Factor XIa
EC 3.4.21.27
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
32-38Subventions
Organisme : NIAID NIH HHS
ID : R01 AI157037
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL101972
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL144113
Pays : United States
Organisme : NHLBI NIH HHS
ID : R35 HL140025
Pays : United States
Informations de copyright
© 2021 International Society on Thrombosis and Haemostasis.
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