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 , Xi Chen , Yueyun Jiang , Yugang Dong , Chen Liu , Yili Chen , Gregory Y.H. Lip , 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 , Xi Chen , Yueyun Jiang , Yugang Dong , Chen Liu , Yili Chen , Gregory Y.H. Lip , 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}
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.
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.