Anti-Blood Clotting Drug Milvexian Lowers Stroke Risk

Milvexian, an experimental drug designed to inhibit blood-clotting proteins, shows promise in reducing the likelihood of recurrent strokes. (1 Trusted Source
Safety and efficacy of factor XIa inhibition with milvexian for secondary stroke prevention (AXIOMATIC-SSP)

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Stroke is the leading cause of disability worldwide and the second leading cause of death. While one in four people is estimated to have a stroke in their lifetime, many also go on to experience another stroke.

“When patients have transient neurological symptoms due to a minor stroke, we have medications that prevent them from having a further stroke. But despite those medications, a lot of people still go on to have another stroke,” said Richard Bernstein, Professor Department of Neurology’s Division of Stroke and Vascular Neurology at Northwestern University in the US.

Milvexian’s Impact on Ischemic Stroke Risk Investigated

Previous research has shown that people with a deficiency of factor XI — a protein known to play a role in blood coagulation, have lower rates of ischemic stroke, the most common type of stroke during which a blood clot blocks the flow of blood and oxygen to the brain.

The new study, published in The Lancet Neurology, aimed to examine the effects of milvexian — a drug designed to inhibit factor XI. The team randomly assigned more than 2,300 people to receive a regimen of anti-blood clotting medications along with different once- or twice-daily doses of milvexian.

“It seems like the drug does work to prevent clinical stroke. We don’t know that for sure, but it seems like it, and that has allowed us to pick a dose that hits that sweet spot of lowering the risk of stroke without raising the risk of bleeding too much,” Bernstein said.

“This study also allowed us to observe that counting up strokes on the MRI may not be a good way to tell if these drugs work, and this was the first large study that really tried to use this method, so we’re not going to try that again.”Moving forward, Bernstein and his collaborators will use the study findings to identify a recommended dose to test in a large clinical trial, he said.


  1. Safety and efficacy of factor XIa inhibition with milvexian for secondary stroke prevention (AXIOMATIC-SSP) – (


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