Hamostaseologie 2024; 44(01): 049-058
DOI: 10.1055/a-2202-8620
Review Article

Reshaping Anticoagulation: Factor XI Inhibition in Thrombosis Management

Andreas Verstraete
1   Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
Matthias M. Engelen
1   Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
Charlotte Van Edom
1   Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
Thomas Vanassche
1   Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
Peter Verhamme
1   Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
› Author Affiliations


Factor XI is almost dispensable for haemostasis, but its role in thrombosis has become increasingly clear. Targeting factor XI could potentially prevent thrombosis with little or no effect on haemostasis. This review explains the underlying mechanisms of thrombosis and haemostasis and elucidates the rationale for factor XI inhibitors based on the pathophysiology and epidemiological and pre-clinical data. It further outlines the different modes for factor XI inhibition. Finally, the article provides an overview of the current clinical evidence and the ongoing trials for factor XI inhibitors in various clinical indications.


Faktor XI spielt eine entscheidende Rolle bei der Thrombose, ist jedoch für die Hämostase nahezu entbehrlich. Die gezielte Beeinflussung von Faktor XI könnte daher dazu beitragen, Thrombose von der Hämostase zu trennen. Diese Übersichtsarbeit erläutert die zugrunde liegenden Mechanismen von Thrombose und Hämostase und erläutert die Begründung für die Verwendung von Faktor-XI-Inhibitoren auf der Grundlage der Pathophysiologie sowie epidemiologischer und präklinischer Daten. Darüber hinaus werden die vielfältigen Ansätze zur Faktor-XI-Inhibition beschrieben. Schließlich bietet der Artikel einen umfassenden Überblick über die bestehenden klinischen Belege für Faktor-XI-Inhibitoren in verschiedenen klinischen Kontexten und stellt eine Übersicht über laufende Studien bereit.

Authors' Contribution

A.V. reviewed the literature, wrote the manuscript, designed the tables and made adjustments according to the suggestions of the co-authors. C.V.E. designed the figure. P.V. supervised this paper. M.M.E., T.V, C.V.E. and P.V. critically reviewed the manuscript.

Publication History

Received: 26 October 2023

Accepted: 16 November 2023

Article published online:
20 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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