ESCCongress Could investigational agents targeting Factor XI, which is higher up the clotting cascade deliver efficacy, without the cost of bleeding.
. Some of us remember from medical school two pathways, but we needn't get into the details. We've ignored factor XI for many years, but now there's a new insight that perhaps it's the ideal target for a new anticoagulant.The problem with anticoagulation is that everything that reduces thrombosis also increases bleeding, but there's something special — at least that's the idea — here.Exactly. That's where the two pathways come in.
We can leverage this dissociation. If we target factor XI, we can stop a pathologic clot from forming but still allow normal clot formation.Indeed. We've heard it before in the development of antithrombotics. We love to hear about molecules that are going to do the right thing and have no side effects. It remains to be demonstrated that targeting factor XI will achieve this holy grail of antithrombotic therapy. We need the trials for that.
Indeed. Many things make sense, so we deliver a hypothesis. That's why we do the science. The world loves new hypotheses. We, as clinicians, love these new concepts. But, unless we do the proper randomized trials, we don't know the answer or the truth. Many of our hypotheses are ultimately proven to be wrong.
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