因子XI/XIa抑制剂在房颤患者中的应用:当前进展和未来展望

IF 12.4 1区 医学 Q1 CELL BIOLOGY
Yue Fan , Xi Chen , Yueyun Jiang , Yugang Dong , Chen Liu , Yili Chen , Gregory Y.H. Lip , Wengen Zhu
{"title":"因子XI/XIa抑制剂在房颤患者中的应用:当前进展和未来展望","authors":"Yue Fan ,&nbsp;Xi Chen ,&nbsp;Yueyun Jiang ,&nbsp;Yugang Dong ,&nbsp;Chen Liu ,&nbsp;Yili Chen ,&nbsp;Gregory Y.H. Lip ,&nbsp;Wengen Zhu","doi":"10.1016/j.arr.2025.102895","DOIUrl":null,"url":null,"abstract":"<div><div>Stroke prevention is one of the pillars of management in elderly patients with atrial fibrillation (AF), hence effective and safe anticoagulation strategies are needed. While available anticoagulants target coagulation factors involved in thrombus formation, their bleeding complications and limitations in aging populations underscore the necessity for novel agents. Factor XI/XIa (FXI/XIa), which selectively targets the intrinsic coagulation pathway, offers a promising approach by attenuating thrombin generation without impairing hemostasis. Various novel inhibitors, including antisense oligonucleotides, monoclonal antibodies and small molecules, have been developed. Clinical trials have shown favorable safety profiles with reduced bleeding risks compared to traditional anticoagulants. Some efficacy in preventing thromboembolic events has also been demonstrated, with ongoing trials further evaluating long-term safety and efficacy. This narrative review explores the potential of FXI/XIa inhibitors as a novel anticoagulant approach for AF. We discuss the rationale, pharmacology, evidence and future directions to assess the application prospects of FXI/XIa inhibitors in elderly AF patients, highlighting their potential to improve anticoagulation therapy by decoupling thrombosis prevention from bleeding complications.</div></div>","PeriodicalId":55545,"journal":{"name":"Ageing Research Reviews","volume":"112 ","pages":"Article 102895"},"PeriodicalIF":12.4000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of factor XI/XIa inhibitors in patients with atrial fibrillation: Current progress and future prospects\",\"authors\":\"Yue Fan ,&nbsp;Xi Chen ,&nbsp;Yueyun Jiang ,&nbsp;Yugang Dong ,&nbsp;Chen Liu ,&nbsp;Yili Chen ,&nbsp;Gregory Y.H. Lip ,&nbsp;Wengen Zhu\",\"doi\":\"10.1016/j.arr.2025.102895\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Stroke prevention is one of the pillars of management in elderly patients with atrial fibrillation (AF), hence effective and safe anticoagulation strategies are needed. While available anticoagulants target coagulation factors involved in thrombus formation, their bleeding complications and limitations in aging populations underscore the necessity for novel agents. Factor XI/XIa (FXI/XIa), which selectively targets the intrinsic coagulation pathway, offers a promising approach by attenuating thrombin generation without impairing hemostasis. Various novel inhibitors, including antisense oligonucleotides, monoclonal antibodies and small molecules, have been developed. Clinical trials have shown favorable safety profiles with reduced bleeding risks compared to traditional anticoagulants. Some efficacy in preventing thromboembolic events has also been demonstrated, with ongoing trials further evaluating long-term safety and efficacy. This narrative review explores the potential of FXI/XIa inhibitors as a novel anticoagulant approach for AF. We discuss the rationale, pharmacology, evidence and future directions to assess the application prospects of FXI/XIa inhibitors in elderly AF patients, highlighting their potential to improve anticoagulation therapy by decoupling thrombosis prevention from bleeding complications.</div></div>\",\"PeriodicalId\":55545,\"journal\":{\"name\":\"Ageing Research Reviews\",\"volume\":\"112 \",\"pages\":\"Article 102895\"},\"PeriodicalIF\":12.4000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ageing Research Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1568163725002417\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CELL BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ageing Research Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1568163725002417","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CELL BIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

卒中预防是老年心房颤动(AF)患者管理的支柱之一,因此需要有效和安全的抗凝策略。虽然现有的抗凝药物是针对参与血栓形成的凝血因子,但它们的出血并发症和在老年人群中的局限性强调了开发新型抗凝药物的必要性。因子XI/XIa (FXI/XIa)选择性靶向内在凝血途径,提供了一种很有前途的方法,可以在不损害止血的情况下减少凝血酶的产生。各种新型抑制剂,包括反义寡核苷酸、单克隆抗体和小分子,已经被开发出来。临床试验显示,与传统抗凝剂相比,安全性较好,出血风险降低。一些预防血栓栓塞事件的有效性也已被证明,正在进行的试验进一步评估长期安全性和有效性。本文探讨了FXI/XIa抑制剂作为一种新型房颤抗凝治疗方法的潜力。我们讨论了FXI/XIa抑制剂在老年房颤患者中的应用前景的理论基础、药理学、证据和未来的发展方向,强调了FXI/XIa抑制剂通过将血栓预防与出血并发症分离来改善抗凝治疗的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of factor XI/XIa inhibitors in patients with atrial fibrillation: Current progress and future prospects
Stroke prevention is one of the pillars of management in elderly patients with atrial fibrillation (AF), hence effective and safe anticoagulation strategies are needed. While available anticoagulants target coagulation factors involved in thrombus formation, their bleeding complications and limitations in aging populations underscore the necessity for novel agents. Factor XI/XIa (FXI/XIa), which selectively targets the intrinsic coagulation pathway, offers a promising approach by attenuating thrombin generation without impairing hemostasis. Various novel inhibitors, including antisense oligonucleotides, monoclonal antibodies and small molecules, have been developed. Clinical trials have shown favorable safety profiles with reduced bleeding risks compared to traditional anticoagulants. Some efficacy in preventing thromboembolic events has also been demonstrated, with ongoing trials further evaluating long-term safety and efficacy. This narrative review explores the potential of FXI/XIa inhibitors as a novel anticoagulant approach for AF. We discuss the rationale, pharmacology, evidence and future directions to assess the application prospects of FXI/XIa inhibitors in elderly AF patients, highlighting their potential to improve anticoagulation therapy by decoupling thrombosis prevention from bleeding complications.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Ageing Research Reviews
Ageing Research Reviews 医学-老年医学
CiteScore
19.80
自引率
2.30%
发文量
216
审稿时长
55 days
期刊介绍: With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信