Abstract
Currently used anticoagulation agents (factor Xa inhibitors, thrombin inhibitors and antivitamin K) dominantly block the common coagulation pathway. The most frequent anticoagulant indication is blood stagnation and activation of reparatory and inflammatory processes (atrial fibrillation or thromboembolic disease).
Therefore, a selective influence on the intrinsic pathway of the coagulation cascade is an option so that the hemostasis initiated by blood vessel wall disruption is preserved. The most promising way supported by evidence of efficacy and safety is factor XI inhibition.
Other strategies are being investigated - blockade with monoclonal antibodies (abelacimab and osocimab) or classic small molecules (asundexian and milvexian) and factor XI synthesis blockade with inhibitory oligonucleotides called antisense oligonucleotides. In recent years, this area of expertise has reached advanced phases of clinical evaluation, and new exciting data have emerged.