Venous thromboembolism prevention and treatment with factor XI/XIa inhibitors: current status and future perspectives.

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Thrombosis and Thrombolysis Pub Date : 2025-07-08 DOI:10.1007/s11239-025-03132-z

Raul Del Toro-Mijares, Mateo Porres-Aguilar, Laurent Bertoletti, Alfonso J Tafur, Ilham Benzidia, Guillermo Cueto-Robledo, James D Douketis

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引用次数: 0

Abstract

Current treatments for venous thromboembolism include warfarin, various heparins, and direct oral anticoagulants. While effective, there's ongoing research for safer alternatives, especially for high-risk patients (e.g., cancer, post-operative, and those with end-stage renal disease). Factor XI has been identified as crucial in abnormal thrombosis but less so in normal hemostasis, suggesting that inhibiting it could reduce thrombosis while also limiting bleeding risks. Recent phase 2 trials on factor XI inhibitors show promise for preventing venous thromboembolism in patients undergoing total knee arthroplasty, in cancer patients, and in patients with end-stage renal disease. Three key unmet needs include: need for large-scale phase 3 clinical trials, broader surgical applications and management of bleeding complications/reversal strategies. Further research on these aspects is essential, especially as factor XI inhibitors progress towards clinical use.

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因子XI/XIa抑制剂预防和治疗静脉血栓栓塞：现状和未来展望

目前静脉血栓栓塞的治疗包括华法林、各种肝素和直接口服抗凝剂。虽然有效，但目前仍在研究更安全的替代品，特别是对高风险患者（如癌症、手术后和终末期肾病患者）。已确定因子XI在异常血栓形成中起关键作用，但在正常止血中作用较弱，表明抑制它可以减少血栓形成，同时限制出血风险。最近关于因子XI抑制剂的2期临床试验显示，它有望预防全膝关节置换术患者、癌症患者和终末期肾病患者的静脉血栓栓塞。未满足的三个关键需求包括：大规模三期临床试验的需求、更广泛的手术应用和出血并发症的管理/逆转策略。这些方面的进一步研究是必要的，特别是随着因子XI抑制剂在临床应用方面的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Thrombosis and Thrombolysis 医学-外周血管病

CiteScore

9.20

自引率

0.00%

发文量

112

审稿时长

4-8 weeks

期刊介绍： The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care. The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.