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December 8, 2025BloodOpen Access

Evaluating reversal strategies for long-acting factor XI antibodies: RFVIIa®, FEIBA®, Kcentra®, novel FXI mutants, and an anti-idiotypic antibody

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Authors

DGDavid GailaniCLChristina U. Lorentz

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Overview

Laboratory analysis reveals specific reversal agents improve coagulation in plasma with factor XI inhibitors, suggesting new tailored therapies.

Key Points

  • This research investigates the effectiveness of various reversal strategies for factor XI antibodies during bleeding events.
  • Evaluated reversal agents in human plasma spiked with FXI or FXIa antibodies.
  • Performed global coagulation assays including activated partial thromboplastin time and thrombin generation assay.
  • Used viscoelastic testing of whole blood with ROTEM (NATEM protocol).
  • FXI inhibitors prolonged aPTT without affecting PT.
  • NovoSeven® and FEIBA® effectively restored aPTT and thrombin generation, while Kcentra® did not.
  • Specific reversal agents showed partial to complete normalization of coagulation parameters.

Cite This Study

Gailani et al. (2025) studied this question.

synapsesocial.com/papers/69362f6e4fa91c937236e104https://doi.org/10.1182/blood-2025-4835
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1FACTOR XI INHIBITORS AS THE NEXT GENERATION OF ANTICOAGULANTS: A COMPREHENSIVE PHARMACOLOGICAL REVIEW OF ASUNDEXIAN, MILVEXIAN, ABELACIMAB, FESOMERSEN, AND THE DECOUPLING OF THROMBOSIS FROM HEMOSTASIS2026
  2. 2Pharmacology and Clinical Development of Factor XI Inhibitors2023 · 143 citations
  3. 3Factor XI and XIa Inhibitors: A State-of-the-Art Review Across Clinical Indications2026
  4. 4Reversal Agents for the Direct Factor Xa Inhibitors: Biochemical Mechanisms of Current and Newly Emerging Therapies2020 · 14 citations
  5. 5Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors2015 · 3 citations