What is the Future Position of Factor XIa Inhibitors for Patients with Atrial Fibrillation?

Factor XIa (FXIa) may be involved in thrombus formation, but only to a lesser extent involved in haemostasis. Several novel FXIa inhibitors are under investigation, and Phase II trials demonstrated marked reduction of bleeding compared with standard treatment by factor Xa inhibitors. Asundexian is a small molecule that selectively inhibits FXIa. A large-scale Phase III clinical trial, OCEANIC-AF, has been initiated to compare the efficacy and safety between asundexian and apixaban. However, the OCEANIC-AF study was recently halted due to the inferior efficacy of asundexian versus the apixaban control arm. The present report describes up-to-date evidence of FXIa inhibitors and discusses the future position of FXIa inhibitors for patients with AF.

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Copyright © The Author(s), 2024. Published by Radcliffe Group Ltd.

Déclaration de conflit d'intérêts

Disclosure: TI has received lecture honoraria from Bayer, Daiichi Sankyo and Pfizer. GAD and KH are on the European Cardiology Review editorial board; this did not influence peer review. All other authors have no conflicts of interest to declare. Funding: Grant-in-aid for clinical research from the National Hospital Organisation, Japan.