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凝血因子XI抑制剂是治疗与年龄相关血栓性疾病的新型有前景的抗凝剂。

Factor XI inhibitors are the novel promising anticoagulants in the treatment of age related thrombotic disease.

作者信息

Feng Dandan, Wang Jianchun

机构信息

Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

出版信息

Front Cardiovasc Med. 2025 May 30;12:1498826. doi: 10.3389/fcvm.2025.1498826. eCollection 2025.

DOI:10.3389/fcvm.2025.1498826
PMID:40520928
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12162611/
Abstract

The incidence and mortality of thrombotic diseases in the aged population are increasing year by year, which seriously affect the quality of life of the elderly. At present, antithrombotic drugs used in clinical practice have good efficacy, but they caused different degrees of age-dependent bleeding risk. Therefore, there is an urgent need to develop effective antithrombotic drugs with less risk of bleeding. Recent studies have shown that factor Ⅺ inhibitors can effectively reduce the incidence of thromboembolic events without increasing the risk of bleeding. Therefore, factor Ⅺ inhibitors are expected to be safe and effective new anticoagulants, providing a new sight for the prevention and treatment of thrombotic diseases. This paper reviews the biological functions of factor Ⅺ, the types and characteristics of factor Ⅺ inhibitors and the related research progress of factor Ⅺ inhibitors.

摘要

老年人群中血栓性疾病的发病率和死亡率逐年上升,严重影响老年人的生活质量。目前,临床实践中使用的抗血栓药物疗效良好,但会引发不同程度的年龄依赖性出血风险。因此,迫切需要开发出血风险较低的有效抗血栓药物。最近的研究表明,因子Ⅺ抑制剂可有效降低血栓栓塞事件的发生率,且不增加出血风险。因此,因子Ⅺ抑制剂有望成为安全有效的新型抗凝剂,为血栓性疾病的防治提供新视角。本文综述了因子Ⅺ的生物学功能、因子Ⅺ抑制剂的类型和特点以及因子Ⅺ抑制剂的相关研究进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba2/12162611/b0ef47a25822/fcvm-12-1498826-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba2/12162611/b0ef47a25822/fcvm-12-1498826-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba2/12162611/b0ef47a25822/fcvm-12-1498826-g001.jpg

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本文引用的文献

1
A new strategy for anticoagulation: The factor XI inhibitors.一种新的抗凝策略:因子 XI 抑制剂。
Eur J Intern Med. 2023 Oct;116:8-15. doi: 10.1016/j.ejim.2023.08.001. Epub 2023 Aug 4.
2
Pharmacology and Clinical Development of Factor XI Inhibitors.因子 XI 抑制剂的药理学和临床开发。
Circulation. 2023 Mar 14;147(11):897-913. doi: 10.1161/CIRCULATIONAHA.122.062353. Epub 2023 Mar 13.
3
Factor XIa inhibition with asundexian after acute non-cardioembolic ischaemic stroke (PACIFIC-Stroke): an international, randomised, double-blind, placebo-controlled, phase 2b trial.
急性非心源性缺血性脑卒中后用 asundexian 抑制因子 XIa(PACIFIC-Stroke):一项国际、随机、双盲、安慰剂对照、2b 期试验。
Lancet. 2022 Sep 24;400(10357):997-1007. doi: 10.1016/S0140-6736(22)01588-4. Epub 2022 Sep 2.
4
Rivaroxaban in Rheumatic Heart Disease-Associated Atrial Fibrillation.利伐沙班在风湿性心脏病相关心房颤动中的应用。
N Engl J Med. 2022 Sep 15;387(11):978-988. doi: 10.1056/NEJMoa2209051. Epub 2022 Aug 28.
5
Effects of Itraconazole and Diltiazem on the Pharmacokinetics and Pharmacodynamics of Milvexian, A Factor XIa Inhibitor.伊曲康唑和地尔硫䓬对XIa因子抑制剂米尔韦克辛药代动力学和药效学的影响。
Cardiol Ther. 2022 Sep;11(3):407-419. doi: 10.1007/s40119-022-00266-6. Epub 2022 May 31.
6
Apixaban vs. standard of care after transcatheter aortic valve implantation: the ATLANTIS trial.阿哌沙班与经导管主动脉瓣置换术后标准治疗的比较:ATLANTIS 试验。
Eur Heart J. 2022 Aug 1;43(29):2783-2797. doi: 10.1093/eurheartj/ehac242.
7
Making anticoagulation safer.让抗凝治疗更安全。
Lancet. 2022 Apr 9;399(10333):1360-1361. doi: 10.1016/S0140-6736(22)00563-3. Epub 2022 Apr 3.
8
Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study.口服因子 XIa 抑制剂 asundexian 与房颤患者的阿哌沙班(PACIFIC-AF)相比的安全性:一项多中心、随机、双盲、双模拟、剂量发现的 2 期研究。
Lancet. 2022 Apr 9;399(10333):1383-1390. doi: 10.1016/S0140-6736(22)00456-1. Epub 2022 Apr 3.
9
Milvexian for the Prevention of Venous Thromboembolism.密尔沃基用于预防静脉血栓栓塞。
N Engl J Med. 2021 Dec 2;385(23):2161-2172. doi: 10.1056/NEJMoa2113194. Epub 2021 Nov 15.
10
A proposal for managing bleeding in patients on therapeutic factor XI(a) inhibitors.治疗性因子 XI(a)抑制剂患者出血管理的建议。
J Thromb Haemost. 2022 Jan;20(1):32-38. doi: 10.1111/jth.15579. Epub 2021 Nov 21.