The New Frontier of Antithrombotic Therapy: Safety and Efficacy of Factor XIa Inhibition

In this episode, titled ‘The New Frontier of Antithrombotic Therapy: Safety and Efficacy of Factor XIa Inhibition’, neurology experts dive into the clinical trial data for emerging Factor XIa inhibitors, exploring their potential to redefine stroke prevention. Mark Makhinson leads the panel through a detailed discussion on the following questions:

Let’s start with asundexian, which is under investigation in non-cardioembolic ischemic strokes. Which patients were included in this trial and what was the overall trial data?

What have the data demonstrated for milvexian so far and what is the trial design for the LIBREXIA STROKE and AF studies?

Which patients were investigated and what have the data revealed so far for abelacimab in terms of safety and efficacy?

The experts discuss the landmark OCEANIC-STROKE trial, noting its massive enrollment of over 12,000 patients and the significant 26% relative risk reduction in ischemic stroke with asundexian—all while maintaining a safety profile comparable to placebo. David Rose highlights the durability of these results over a three-year period, while Danison Emmerson provides insights into the LIBREXIA program, emphasizing the inclusion of patients on dual antiplatelet therapy (DAPT). Finally, Andrew Russman addresses the AZALEA-TIMI 71 study for abelacimab, comparing its safety against rivaroxaban in atrial fibrillation and discussing the future of the LILAC-TIMI 76 study. The conversation underscores a pivotal shift toward non-cardioembolic ischemic stroke (NCIS) as the primary target for these novel therapies.

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, ‘[Episode 10 Title]’, the panel will conclude their discussion by synthesizing these clinical findings and providing a vision for the future of individualized stroke care.

In the next episode, ‘The Future of Factor XIa Inhibition: Clinical Integration and Treatment Algorithms’, the panel will continue their discussion by synthesizing these clinical findings and providing a vision for the future of individualized stroke care.