Keywords
sangrados
Factor XI
How to Cite
Abstract
Currently available anticoagulants act by interfering in the synthesis of multiple coagulation factors or by specifically inhibiting factors of the common pathway; this affects hemostasis with the consequent increased risk of bleeding. The fear of bleeding continues to limit the indication of anticoagulants. The intrinsic pathway has been shown to play a more important role in the development of thrombosis than in hemostasis. For this reason, in recent years, it has been the focus of study for the development of new anticoagulants with a better safety profile. Several agents that inhibit FXI at different staging, including antisense oligonucleotides, monoclonal antibodies and small molecules have been developed. Abelacimab, a monoclonal antibody, has shown promising efficacy and safety results in phase 2 studies and meta-analyses. It was the first to be evaluated in phase 3 studies, so we will soon have more evidence and a better perspective on its possible clinical application.
References
Sanghai S, Wong C, Wang Z y col. Rates of PotentiallyInappropriate Dosing of Direct-Acting Oral Anticoagulants and Associations With Geriatric Conditions Among Older Patients With Atrial Fibrillation: The SAGE-AF Study. J Am Heart Assoc. 2020;9(6):e014108.
Steffel J, Collins R, Antz M y col. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. Europace. 2021;23(10):1612-1676.
Dufrost V, Wahl D, Zuily S. Direct oral anticoagulants in antiphospholipid syndrome: Meta-analysis of randomized controlled trials. Autoimmun Rev. 2021;20(1):102711.
Zhang H, Löwenberg EC, Crosby JR et al. Inhibition of the intrinsic coagulation pathway factor XI by antisense oligonucleotides: a novel antithrombotic strategy with lowered bleeding risk. Blood. 2010;116(22):4684- 4692.
Hoffman M, Monroe DM 3rd. A cell-based model of hemostasis. Thromb Haemost. 2001;85(6):958-965.
De Caterina R, Prisco D, Eikelboom JW. Factor XI inhibitors: cardiovascular perspectives. Eur Heart J. 2023;44(4):280-292.
Lewandowska MD, Connors JM. Factor XI Deficiency. Hematol Oncol Clin North Am. 2021;35(6):1157-1169.
Preis M, Hirsch J, Kotler A y col. Factor XI deficiency is associated with lower risk for cardiovascular and venous thromboembolism events. Blood. 2017;129(9):1210-1215.
Cohen O, Ageno W. Coming soon to a pharmacy near you? FXI and FXII inhibitors to prevent or treat thromboembolism. Hematology Am Soc Hematol Educ Program. 2022;2022(1):495-505. 10. De Caterina R, Prisco D, Eikelboom JW. Factor XI inhibitors: cardiovascular perspectives. Eur Heart J. 2023;44(4):280-292.
Yi BA, Freedholm D, Widener N y col. Pharmacokinetics and pharmacodynamics of Abelacimab (MAA868), a novel dual inhibitor of Factor XI and Factor XIa. J Thromb Haemost. 2022;20(2):307-315.
Verhamme P, Yi BA, Segers A y col. Abelacimab for Prevention of Venous Thromboembolism. N Engl J Med. 2021;385(7):609-617.
Galli M, Laborante R, Ortega-Paz L y col. Factor XI Inhibitors in Early Clinical Trials: A Meta-analysis. Thromb Haemost. 2023;10.1055/a-2043-0346.
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