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December 8, 2025BloodOpen Access

Evaluating reversal strategies for long-acting factor XI antibodies: RFVIIa®, FEIBA®, Kcentra®, novel FXI mutants, and an anti-idiotypic antibody

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Authors

DGDavid GailaniCLChristina U. Lorentz

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Overview

Observational analysis evaluated thrombin generation and reversal in human plasma, suggesting strategies tailored to factor XI antibodies may improve outcomes.

Key Points

  • Thrombin generation was significantly reduced by factor XI inhibitors across multiple assays, highlighting the need for effective reversal strategies.
  • Global coagulation assays showed that activated prothrombin complex concentrate improved coagulation parameters compared to untreated plasma conditions.
  • Assessment using viscoelastic testing indicated that varying bypassing agents could create transient procoagulant states if misapplied.
  • Findings underscore the importance of tailoring reversal approaches to the specific mechanisms of factor XI inhibitors for optimal patient outcomes.

Cite This Study

Gailani et al. (2025) studied this question.

synapsesocial.com/papers/69362f6e4fa91c937236e104https://doi.org/10.1182/blood-2025-4835
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Factor XIa inhibition for the prevention of thrombosis: mechanism, clinical trial signals, and indication-specific positioning2026
  2. 2The Discovery of a Novel Anticoagulant Mechanism: Factor XI Activation Inhibitors2025 · 1 citations
  3. 3Use of Factor XI/XIa Inhibitors in Patients with Atrial Fibrillation: Current Progress and Future Prospects2025
  4. 4Rebalancing agents in hemophilia: knowns, unknowns, and uncertainties2025 · 8 citations
  5. 5PO38 | Rates of hemorrhagic events and hemodialysis circuit thrombosis in patients with end-stage renal disease on hemodialytic treatment receiving a factor-XI inhibitor: a systematic review and meta-analysis2025