Drug
Milvexian is an investigational oral factor XIa inhibitor; it is not FDA approved.
Sources: 3 registered trials
3 experts quoted, 2 with a clear stance so far. We show the split once 3 have one.
Expert labels are toward LIBREXIA ACS's result, from named public quotes (n=2). As of Aug 29, 2026.
Mechanism: factor XIa inhibitor · Synapse curated drug list
Dosing is left to the label.
Registered trials with milvexian in an arm, past phase 1 with at least 50 participants: the largest in each indication, newest first. Trials that give it only as the comparator are tagged; trials that give it in every arm are listed last.
NCT05757869 · Phase 3 · Active not recruiting · 20,284 participants · started 2023
NCT05754957 · Phase 3 · Completed · 14,194 participants · started 2023
Stroke
NCT05702034 · Phase 3 · Active not recruiting · 12,532 participants · started 2023
Source: ClinicalTrials.gov registry records.
Class membership: Synapse curated drug classes
A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.
Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.
Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.
The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.