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Doctors & patients are saying about 'Beat Your A-Fib'...


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Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


New Anticoagulant with less Bleeding Risk―Asundexian Factor XI (Bayer)

Today’s anticoagulants (DOACs-Direct Oral Anticoagulants) have a residual risk of major bleeding of 1.5-3.6%/year. That means that after stopping a DOAC anticoagulant, the effects can continue to affect you for 1½ to 3½ years afterward.

The result is you continue to be at a higher risk of major bleeding even though you are no longer taking the anticoagulant.

Alarming, bleeding events remain a high risk for you.

These bleeding events are associated with increased mortality, high costs, and compromised adherence to treatment. Especially for patients 65 and older, anticoagulants increase the risk of hemorrhagic-type strokes. (For more about anticoagulants, see my post: Anticoagulants Increase Risk of Hemorrhagic-Type Strokes.)

Pacific-AF clinical trials

Drug to Reduce Bleeding Event in Clinical Trial

Currently the PACIFIC-AF clinical trials is studying Asundexian, a new anticoagulant. Asundexian is an oral factor XI (FXIa inhibitor). Early clinical results indicate that FXIa inhibition works to prevent stroke with reduced bleeding risk. Clinical trials and phases are continuing.

If FXIa inhibition proves to be safer and as effective as existing DOACs, it would be a major advance in stroke-prevention therapy.

References
• Sandro Ninni, Stanley Nattel. Factor xia inhibition in atrial Fibrillation: insights and knowledge gaps emerging from the PACIFIC-AF trial. Cardiovascular Research, cvac196. January 25, 2023, https://academic.oup.com/cardiovascres/advance-article/doi/10.1093/cvr/cvac196/7005367. https://doi.org/10.1093/cvr/cvac196

• Piccini JP, et al. PACIFIC-AF Investigators. Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study. Lancet. 2022 Apr 9;399(10333):1383-1390. doi: 10.1016/S0140-6736(22)00456-1. Epub 2022 Apr 3. PMID: 35385695.

• Rhoads, Allison T. Clinical Overview: Asundexian for Secondary Prevention in Patients With Non-Cardioembolic Ischemic Stroke Pharmacy Times. May 16, 2022. https://www.pharmacytimes.com/view/clinical-overview-asundexian-for-secondary-prevention-in-patients-with-non-cardioembolic-ischemic-stroke

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