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While DOACs are Good for Some Things, They Are Not for Everyone

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New Frontiers in Anticoagulation: Factor XI/XIa Inhibitors

While DOACs are Good for Some Things, They Are Not for Everyone

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  • Overview

    Anticoagulation has transformed the management of multiple potentially catastrophic disease states. Currently, available anticoagulation agents work on the common pathway of the coagulation cascade, inhibiting both thrombosis as well as hemostasis and increasing the risk of serious bleeding. Factor XIa inhibitors may completely change this anticoagulation landscape. Factor XIa affects the intrinsic thrombosis pathway, preserving the extrinsic and common pathways. Phase 2 data on multiple factor XIa inhibitors support a favorable safety profile for implementation, with reduced risk of bleeding being a consistent theme, for VTE prophylaxis, secondary stroke prevention in atrial fibrillation (AF), post-myocardial infarction (MI), and post-non-embolic stroke. This program explores novel factor XIa inhibitors currently under investigation and outlines anticoagulation’s exciting future.

  • Target Audience

    This activity has been designed to meet the educational needs of the interdisciplinary team approach intended for clinical cardiologists, emergency medicine physicians, hematologists, hospitalists, neurologists, primary care physicians, vascular medicine practitioners, and vascular surgeons, as well as other clinicians involved in the management of patients with anticoagulation.

  • Learning Objectives

    After participating in this educational activity, participants should be better able to: 

    • Review the currently available therapeutics and how they affect multiple pathways involved in the coagulation cascade, thereby increasing the potential for serious bleeds
    • Review current decision pathways for initiation of anticoagulation treatment and shared patient-physician decision-making, emphasizing potential prescriber bias that limits more widespread adoption of DOAC therapy
    • Review cardiac and non-cardiac patient populations where DOACs have limitations or contraindications
    • Discuss factor XI and factor XIa inhibition and review new and emerging anticoagulation pharmacotherapy for VTE, AF, secondary stroke prevention, and post-MI
  • Accreditation Statement

    In support of improving patient care, this activity has been planned and implemented by Global Learning Collaborative (GLC) and Total CME, LLC. GLC is jointly accredited by the American Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

    This activity was planned by and for the healthcare team, and learners will receive 1.50 Interprofessional Continuing Education (IPCE) credits for learning and change.

  • Faculty Disclosure of Commercial Relationships

    Disclosure Policy
    In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all educational programs. 

    The following faculty have disclosed:

    Christopher B. Granger, MD, co-chair for this educational event, received research grants or contracts from Alnylam Pharm., Boehringer Ingelheim, Bristol Myers Squibb, Duke Clinical Research Institute, FDA, Janssen Pharmaceutica Products, L.P., Lilly Pharmaceutical, Novartis Pharmaceutical Company, Pfizer, and Philips; received consulting fees from Abbvie, Abiomed, Anthos., Bayer Corporation, Boehringer Ingelheim, Boston Scientific Corporation, Bristol Myers Squibb, Cardionomic, CeleCor Therapeutics, HengRui USA, Janssen Pharmaceutica Products, L.P., Medscape, LLC, Medtronic Inc., Merck, NephroSynergy, NIH, Novo Nordisk, Novartis Pharmaceutical Company, Pfizer, Philips, REATA, and Veralox Therapeutics, Inc; and has ownership interest in Tenac.io.

    Manesh R. Patel, MD, co-chair for this educational event, received research grants from AstraZeneca, Bayer, Janssen, Mytonomy, and Procyrion; and received consulting fees from Bayer, Janssen, and Novartis.

    M. Cecilia Bahit, MD, faculty for this educational event, received consulting fees from MSD, Pfizer, Bristol-Myers Squibb, CSL Behring, Janssen, and Boehringer Ingelheim.

    Elaine M. Hylek, MD, MS, faculty for this educational event, received consulting fees from Abbott, Bayer,  Medtronic for Research Executive Steering Committees. 

  • Planners and Managers Disclosure List

    The following planners/reviewers/managers have disclosed:

    William Mencia, MD, FACEHP, CHCP, reviewer for this educational event, has no relevant financial relationships with ineligible companies.

    Total CME, LLC., planners, and managers have no relevant commercial relationships to disclose.

    All the relevant financial relationships for these individuals have been mitigated.

  • Disclaimer

    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and Total CME, LLC. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of MedEd On The Go you are subject to the terms and conditions of use, including copyright and licensing restrictions, of that site.

    Reproduction Prohibited
    Reproduction of this material is not permitted without written permission from the copyright owner.

  • Provider(s)/Educational Partner(s)

    Jointly provided by Global Learning Collaborative (GLC) and Total CME, LLC.

  • Commercial Support

    This activity is supported by an independent educational grant from Bayer HealthCare Pharmaceuticals Inc.

  • Fee Statement

    This activity is FREE to all participants.

  • Instructions for Completion

    During the period 11/30/2023 through 11/30/2024, registered participants wishing to receive continuing education credit for this activity must follow these steps:

    1. Read the learning objectives and faculty disclosures.
    2. Answer a pre-program question.
    3. View the program.
    4. Complete the post-test with a score of 100%. 
    5. Complete activity evaluation.
    6. Apply for credit and either bank your credits or print your certificate.


    For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service. This may require you to add or update the e-profile ID/date of birth information saved in your account.

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Schedule18 Apr 2024