Stroke Prevention in A fib

[Aegean56]

Just wondering if there has been any buzz/chatter about the drug — Abelacimab (MAA868) a monoclonal antibody that binds to the coagulation (clot forming) factor XI and locks it in the inactive state, preventing it from being activated thereby preventing thrombosis i.e. blood clots . It seems to have to a have significant reduction in bleeding risk.

●An unpublished US trial from 2023 comparing bleeding rates in 1287 individuals with atrial fibrillation who were randomly assigned to abelacimab (90 or 150 mg) or rivaroxaban (20 mg once daily) was stopped early because of greater safety with abelacimab [13,14]. Compared with rivaroxaban, abelacimab reduced major and clinically relevant nonmajor bleeding by 67 and 77 percent with the 150 mg and 90 mg doses, respectively. Gastrointestinal bleeding was reduced by 93 percent compared with rivaroxaban. Adverse event rates were similar between abelacimab and rivaroxaban.

Here in the US, it is still considered investigational. I'm curious about the UK/European trials/studies.

[BobD Volunteer]

Not heard of it here in UK and everything on Google about it is US based and still at trial stages.

[FraserB]

I read about Abelacimab and did ask my cardiologist about it (I'm in Canada). But he quickly said it is in trial stages in the U.S. and could be quite a while before it is available.

It would be ideal to see something like this with anticoagulant therapy because of its better safety profile and yet still retain the ability to prevent stroke.

In the meantime I will be taking my apixaban, but do hope the trials go well so we have a new approach (or at least another choice) for anticoagulation.

[Aegean56 in reply to FraserB]

Understood. But a major Gi bleed or hemmoraghic stroke is more frightened and much more like to be catastrophic.

[CDreamer]

I have seen some studies about it, I am very hesitant about biologicals. Although used quite frequently as treatments in other diseases in the early days there were a lot of problems and unforeseen consequences. My neurologist suggested I transfer from immune suppressants to a biological and I had to take a gene test to see if I would be reactive. I have a couple of friends who have had mixed experience of using monoclonal antibodies.

I’m not holding my breath.