December 2023

NEUROSCIENCES

PHASE 2 TRIAL EVALUATES SAFETY AND EFFICACY OF FACTOR XIA INHIBITION WITH MILVEXIAN FOR PREVENTION OF SECONDARY STROKE

Featuring: Richard A. Bernstein, MD, PhD
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People with factor XI deficiency have lower rates of ischaemic stroke than the general population and infrequent spontaneous bleeding, suggesting that factor XI has a more important role in thrombosis than in haemostasis.  Richard A. Bernstein, MD, PhD, of Northwestern Medicine Neurology was part of a phase 2 trial on AXIOMATIC-SSP that was published in The Lancet Neurology. 
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Factor XIa inhibition with milvexian, added to dual antiplatelet therapy, did not substantially reduce the composite outcome of symptomatic ischaemic stroke or covert brain infarction. In addition, it did not meaningfully increase the risk of major bleeding. Findings from this study have informed the design of a phase 3 trial of milvexian for the prevention of ischaemic stroke in patients with acute ischaemic stroke or TIA.
Richard Bernstein, MD, PhD, Lead Author, Professor of Stroke and Vascular Neurology in the Ken and Ruth Davee Department of Neurology at Northwestern Medicine

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