Why the study?
Does asundexian reduce stroke or systemic thromboembolism compared to apixaban in patients with atrial fibrillation?
Does asundexian reduce stroke or systemic thromboembolism compared to apixaban in patients with atrial fibrillation?
In patients with atrial fibrillation, asundexian 50 mg once daily was associated with a significantly higher risk of stroke or systemic thromboembolism compared to apixaban, despite a lower risk of bleeding.
To the Editor: Inhibition of factor XI or activated factor XI (XIa) should provide protection against stroke with a low risk of bleeding, given that the incidence of bleeding or adverse cardiovascular events is low among persons with intrinsic factor XI deficiency. In the OCEANIC-AF trial reported by Piccini et al. (Jan. 2 issue), 1 patients who received asundexian at a once-daily dose of 50 mg had a lower risk of bleeding than those who received apixaban; however, asundexian was associated with a higher risk of stroke or systemic thromboembolism than apixaban (hazard ratio, 3.79; 95% confidence interval, 2.46 to 5.83), . . .
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Piccini et al. (2025) studied this question.
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