Future Therapeutic Perspectives: Inhibition of Factor XI
Prospettive terapeutiche future: l’inibizione del fattore XI
Simona Chiusolo, MD; Raffaele De Caterina, MD, PhD
Cardio-Thoracic and Vascular Department, Pisa University Hospital and University of Pisa. Pisa, Italy
Abstract
Con il progredire degli studi in corso, l’inibizione del FXI potrebbe emergere come un’aggiunta preziosa all’arsenale terapeutico anticoagulante, soprattutto per i pazienti con elevato rischio emorragico o controindicazioni alle terapie standard.
Parole chiave: Fattore XI; Anticoagulanti diretti; Terapia anticoagulante; Prevenzione della trombosi; Rischio emorragico.
Abstract
The search for safer and more effective anticoagulant therapies has led to the exploration of Factor XI as a promising target in thrombosis prevention. Unlike traditional anticoagulants that interfere with central components of the coagulation cascade, FXI inhibitors aim to reduce thrombotic risk while minimizing bleeding – a key limitation of current therapies.Multiple FXI-targeting agents are in advanced development, including antisense oligonucleotides, monoclonal antibodies, and small-molecule inhibitors. Early-phase trials in orthopedic surgery, renal disease, and cancer-associated thrombosis have shown encouraging results, particularly with respect to bleeding outcomes. However, recent phase III data in atrial fibrillation have challenged the universal applicability of this approach, suggesting the need for tailored clinical indications.As ongoing trials progress, FXI inhibition may emerge as a valuable addition to the anticoagulation toolkit, particularly for patients with elevated bleeding risk or contraindications to standard therapies.
Key words: Factor XI inhibition; NOACs; Anticoagulation therapy; Thrombosis prevention; Bleeding risk
