Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
May 27, 2023Expert Opinion on Pharmacotherapy

New pharmacotherapeutic options for oral anticoagulant treatment in atrial fibrillation patients aged 65 and older: factor XIa inhibitors and beyond

View Full Paper
Ask AI
Bookmark
Share

Key result

Factor XIa inhibitors emerge as promising DOAC substitutes to lower bleeding risk in elderly AF.

Why the study?

Although anticoagulation reduces stroke risk in non-valvular atrial fibrillation, bleeding remains a major concern, prompting the review of new molecules to minimize bleeding risk in elderly patients.

Do Factor XIa inhibitors provide effective stroke prevention with minimized bleeding risk compared to DOACs in patients aged 65 and older with non-valvular atrial fibrillation?

Design

Systematic review

Authors

GSGiovanni SantostasiGDGentian DenasVPVittorio Pengo

Discussion

Loading...

Member takes

Overview

May support Factor XIa inhibitors in high-bleeding-risk elderly AF; leaves open confirmation of net benefit versus DOACs in RCTs.

Study Design

Type

Systematic Review

Structured PICO

Do Factor XIa inhibitors provide effective stroke prevention with minimized bleeding risk compared to DOACs in patients aged 65 and older with non-valvular atrial fibrillation?

P
Population
Patients aged 65 and older with non-valvular atrial fibrillation
I
Intervention
Factor XIa inhibitors (anti-Factor XI drugs, including oral small molecules)
C
Comparator
Direct oral anticoagulants (DOACs)
O
Outcome
Stroke prevention and bleeding risk

Factor XIa inhibitors represent a promising new class of oral anticoagulants that may offer a safer alternative to DOACs for stroke prevention in elderly patients with atrial fibrillation by potentially uncoupling thrombosis from hemostasis.

Limitations

  • Doubts remain on the possibility of impaired hemostasis, as a fine calibration of inhibition of contact phase factors is crucial for an effective and safe treatment.
  • Doubts remain on the possibility of impaired hemostasis
  • Fine calibration of inhibition is crucial for effective and safe treatment

Cite This Study

Santostasi et al. (2023) conducted a systematic review in Non-valvular atrial fibrillation. Factor XIa inhibitors vs. Direct oral anticoagulants (DOACs) was evaluated. Factor XIa inhibitors are emerging as promising candidates to substitute DOACs for stroke prevention in elderly patients with atrial fibrillation, potentially minimizing bleeding risk.

synapsesocial.com/papers/6a0848251e8b9db648ddfd69https://doi.org/10.1080/14656566.2023.2219391
View Full Paper
Ask AI
Bookmark
Share

Also Consider

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

  1. 1Anticoagulation in patients with kidney failure on dialysis: factor XI as a therapeutic target2021 · 53 citations
  2. 2Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis2022 · 54 citations
  3. 3Effect of Osocimab in Preventing Venous Thromboembolism Among Patients Undergoing Knee Arthroplasty2020 · 259 citations
  4. 4A Phase 2, randomized, partially blinded, active-controlled study assessing the efficacy and safety of variable anticoagulation reversal using the REG1 system in patients with acute coronary syndromes: results of the RADAR trial2012 · 108 citations
  5. 5Epidemiology of cancer-associated venous thrombosis2013 · 1,217 citations