{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:57:20Z","timestamp":1787068640598,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ganzhou City Guiding Science and Technology Plan Project","award":["GZ2024ZSF155 and GZ2024YLJ138"],"award-info":[{"award-number":["GZ2024ZSF155 and GZ2024YLJ138"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is a leading cause of stroke, necessitating effective anticoagulation. While direct oral anticoagulants (DOACs) have improved stroke prevention, bleeding risks remain a concern. Factor XI\/XIa inhibitors, targeting the intrinsic coagulation pathway, offer potential for reduced bleeding, although questions remain regarding their efficacy. This systematic review evaluates the efficacy and safety of Factor XI\/XIa inhibitors compared to DOACs in AF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review of randomized controlled trials (RCTs) comparing Factor XI\/XIa inhibitors with DOACs in AF patients, identified through PubMed and Embase up to January 2025. Data were synthesized narratively due to heterogeneity in study designs and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three RCTs (AZALEA-TIMI 71, OCEANIC-AF, PACIFIC-AF) involving 16\u2005852 patients were included. Factor XI\/XIa inhibitors (abelacimab and asundexian) demonstrated significant reductions in bleeding compared to DOACs. In AZALEA-TIMI 71, abelacimab reduced major or clinically relevant non-major bleeding by 62%-69% versus rivaroxaban. In PACIFIC-AF, asundexian reduced bleeding by 50%-84% compared to apixaban. However, OCEANIC-AF showed asundexian was inferior in stroke prevention, with a 3.8-fold higher risk of stroke or systemic embolism compared to apixaban, leading to early trial termination. Abelacimab showed a trend toward higher ischemic stroke rates abelacimab (150\u2005mg: 1.21 vs 0.59 events\/100 person-years; and 90\u2005mg: 1.24 vs 0.59 events\/100 person-years), though not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Factor XI\/XIa inhibitors significantly reduce bleeding risk in AF patients compared to DOACs, but their thrombotic efficacy remains uncertain. While promising, further research is needed to optimize their use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296251335967","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T10:50:25Z","timestamp":1744714225000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Systematic Review of Factor XI\/XIa Inhibitors Versus Direct Oral Anticoagulants in Patients with Atrial Fibrillation"],"prefix":"10.1177","volume":"31","author":[{"given":"Zhengbiao","family":"Xue","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Gannan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Liao","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine Department, Dayu County People's Hospital, Ganzhou, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiye","family":"Fan","sequence":"additional","affiliation":[{"name":"Gannan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shen","sequence":"additional","affiliation":[{"name":"Gannan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5470-8608","authenticated-orcid":false,"given":"Zhi","family":"Nie","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine Department, Dayu County People's Hospital, Ganzhou, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.017"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031007"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.65347"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.757188"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-024-02100-y"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rceng.2024.01.006"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-2043-0346"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2023.101119"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2406674"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2407105"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00456-1"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/liv.16188"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.10.007"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/10760296241303758"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60040-4"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe2414209"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2024.08.011"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.121.056355"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011373.pub2"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2025.02.013"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251335967","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296251335967","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251335967","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:05:10Z","timestamp":1777385110000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296251335967"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,15]]},"references-count":22,"alternative-id":["10.1177\/10760296251335967"],"URL":"https:\/\/doi.org\/10.1177\/10760296251335967","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,15]]},"article-number":"10760296251335967"}}