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Factor XI Inhibitors: Potential Role in End-Stage Kidney Disease.
- Source :
-
Seminars in nephrology [Semin Nephrol] 2023 Nov; Vol. 43 (6), pp. 151484. Date of Electronic Publication: 2024 Jan 24. - Publication Year :
- 2023
-
Abstract
- Patients with end-stage kidney disease (ESKD) experience a high thrombotic risk but are also at increased risk of bleeding. There is an unmet need for safer antithrombotic therapy in patients with ESKD on hemodialysis. Factor XI (FXI) represents an attractive therapeutic target for anticoagulation because of the potential to mitigate the bleeding risks associated with currently approved anticoagulants, especially in patients at high risk of bleeding. FXI inhibition is also an attractive option in settings where coagulation is activated by exposure of the blood to artificial surfaces, including the extracorporeal circuit during hemodialysis. Therapies targeting FXI that are in the most advanced stages of clinical development include antisense oligonucleotides, monoclonal antibodies, and synthetic small molecules, which serve either to lower FXI levels or block its physiological effects. This review article presents the most recent pharmacological data with FXI inhibitors, briefly describes phase 2 and 3 clinical trials with these agents, and critically examines the potential future use of FXI inhibitors for extracorporeal circuit anticoagulation in patients with ESKD. In addition, laboratory monitoring and reversal of FXI inhibitors are briefly discussed.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Hemorrhage chemically induced
Oligonucleotides, Antisense therapeutic use
Antibodies, Monoclonal therapeutic use
Thrombosis prevention & control
Thrombosis etiology
Kidney Failure, Chronic complications
Kidney Failure, Chronic therapy
Factor XI antagonists & inhibitors
Renal Dialysis
Anticoagulants therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1558-4488
- Volume :
- 43
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Seminars in nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 38272779
- Full Text :
- https://doi.org/10.1016/j.semnephrol.2023.151484