What strategies are being developed to target factor XI and factor XII in the contact pathway?
Strategies to target factor XII or factor XI include antisense oligonucleotides that reduce hepatic synthesis of the clotting proteins, monoclonal antibodies that block activation or activity, aptamers, small molecules that block the active site or induce allosteric modulation, and polyanion antagonists that attenuate contact activation by nullifying stimulators of the pathway. Human data are limited. The factor XI-directed antisense oligonucleotide IONIS-416858 was compared with enoxaparin in 300 patients undergoing elective knee arthroplasty.