Factor XI inhibitors in atrial fibrillation reduce major bleeding but increase ischemic stroke risk compared to DOACs, with modestly lower all-cause mortality.
Do Factor XI/XIa inhibitors improve thromboembolic prevention and safety compared to DOACs in patients with atrial fibrillation?
While Factor XI/XIa inhibitors reduce bleeding compared to DOACs in atrial fibrillation, their increased risk of ischemic stroke raises concerns about their net clinical benefit.
Absolute Event Rate: 0% vs 0%
In patients with atrial fibrillation, Factor XI/XIa inhibitors significantly reduce major and clinically relevant non-major bleeding compared to DOACs but are associated with an increased risk of ischemic stroke. While a modest reduction in all-cause mortality was noted, the unfavorable efficacy profile for stroke prevention raises concerns about the net clinical benefit of the currently evaluated FXI/XIa inhibitors in this population. Further data from ongoing large-scale trials are needed to define their ultimate clinical role.
Alcântara et al. (Mon,) reported a other. Factor XI inhibitors in atrial fibrillation reduce major bleeding but increase ischemic stroke risk compared to DOACs, with modestly lower all-cause mortality.