Factor XI inhibition
the hypothesis, the promise and the LIBREXIA ACS lesson
Factor XI inhibition promises antithrombotic effect without the bleeding cost, but the field keeps hitting reality: after asundexian, the 14,000-patient LIBREXIA ACS trial of milvexian was halted for futility in November 2025. The full results, presented at ESC Congress 2026, will determine what remains of the factor XI hypothesis in ACS, while the AF and stroke programmes continue.
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