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May 2024 Br J Cardiol 2024;31:49–54 doi:10.5837/bjc.2024.018

Factor XI and XIa inhibition: a new approach to anticoagulant therapy

Mark Anthony Sammut, Nadir Elamin, Robert F Storey

Abstract

Introduction Anticoagulant therapy is an essential component in the treatment and prevention of venous and arterial thromboembolic events. In recent years, direct-acting oral anticoagulants (DOACs) have replaced vitamin K antagonists (VKAs) for many of these indications, due to their more favourable risk-benefit profile.1 Despite this, bleeding remains a significant concern with DOACs, especially in patients at high risk, such as those with an indication for concurrent antiplatelet therapy, and may lead to poor adherence or undertreatment.2–4 Safer anticoagulation that spares haemostasis without compromising efficacy is, therefore, desirab

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