Factor XIa Inhibitors Cut Stroke Recurrence Without Added Bleeding Risk

This systematic review and meta-analysis pooled three randomized controlled trials (14,239 participants) comparing factor XIa inhibitors added to antiplatelet therapy versus placebo after acute noncardioembolic ischemic stroke or TIA. The analysis reported reduced risks of any stroke (RR 0.75), ischemic stroke (RR 0.74), and composite cardiovascular events (RR 0.83), with no significant increase in major bleeding, hemorrhagic stroke, intracranial hemorrhage, or all-cause mortality. The authors noted that effect estimates were largely driven by a single phase 3 trial.

Most relevant for: Patients with acute noncardioembolic ischemic stroke or transient ischemic attack on standard antithrombotic therapy.

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