Review
Version 1
Preserved in Portico This version is not peer-reviewed
Drug-Drug Interactions of FXI Inhibitors: Clinical Relevance
Version 1
: Received: 23 January 2024 / Approved: 23 January 2024 / Online: 23 January 2024 (12:31:04 CET)
A peer-reviewed article of this Preprint also exists.
Ferri, N.; Colombo, E.; Corsini, A. Drug–Drug Interactions of FXI Inhibitors: Clinical Relevance. Hematol. Rep. 2024, 16, 151-163. Ferri, N.; Colombo, E.; Corsini, A. Drug–Drug Interactions of FXI Inhibitors: Clinical Relevance. Hematol. Rep. 2024, 16, 151-163.
Abstract
Inhibitors of the factor FXI represent a new class of anticoagulant agents that are facing the clinical approval for the treatment of acute coronary syndrome (ACS), venous thromboembolism (VTE), and stroke prevention of atrial fibrillation (AF). These new inhibitors include chemical small molecules (asundexian and milvexian), monoclonal antibodies (abelacimab, osocimab, and xisomab), and antisense oligonucleotides (IONIS-FXIRX and fesomersen), and thus with very peculiar and different pharmacokinetic and pharmacodynamic properties. Besides their clinical efficacy and safety, based on their pharmacological heterogeneity, the use of these drugs in patients with comorbidities may undergo to drug-drug interactions (DDI) with other concomitant therapies. Although only few clinical evidence are available, it is possible to predict clinical relevant DDI by taking into consideration their pharmacokinetic properties, such as the CYP450-dependent metabolism, the interaction with drug transporters and/or the route of elimination. These characteristics may be useful to differentiate their use with the direct oral anticoagulant (DOAC) anti -FXa (rivaroxaban, apixaban, edoxaban) and thrombin (dabigatran), whose pharmacokinetics are strongly dependent from P-gp inhibitors/inducers. In the present review, we summarize the current clinical evidence on DDI of new anti FXI with CYP450/P-gp inhibitors and inducers and indicate potential differences with DOAC anti FXa.
Keywords
DOAC; FXIa; mAbs; ASO; drug-drug interactions
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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