The Future of Factor XIa Inhibition: Clinical Integration and Treatment Algorithms

In this installment of this series, ‘The Future of Factor XIa Inhibition: Clinical Integration and Treatment Algorithms,’ the experts synthesize the clinical evidence and look toward the future of stroke care. The panel concludes the program by addressing the following key questions:

Where do you envision factor XIa inhibitors fitting into treatment algorithms?

What additional data is needed from these therapies to increase your confidence in them?

The experts reflect on the "flying car" future of stroke prevention, where Factor XIa inhibitors may solve the longstanding dilemma of balancing stroke reduction with bleeding risk. Andrew Russman and the panel discuss the potential for these agents to move from investigational targets to a standard component of secondary prevention protocols, particularly alongside or in place of traditional antiplatelets for high-risk patients. The conversation highlights the "clinical confidence gap," noting that while Phase 3 results like OCEANIC-STROKE are transformative, real-world data on perioperative management and long-term adherence remains the final frontier. Finally, the panelists share their vision for a more accessible, multidisciplinary approach to stroke care that leverages these novel therapies to finally move the needle on long-term patient outcomes.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the final episode, ‘The 5-Year Horizon: Evolving Paradigms in Ischemic Stroke Management’, the participants will explore the near-term future in ischemic stroke management.