Hemostasis Today

February, 2026
February 2026
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Shekher Bose: Asundexian’s Targeted Factor XIa Inhibition May Transform Secondary Stroke Prevention Strategies
Feb 6, 2026, 15:20

Shekher Bose: Asundexian’s Targeted Factor XIa Inhibition May Transform Secondary Stroke Prevention Strategies

Shekher Bose, Client Partner at Beyondsight Intelligence, reposted Beyondsight Intelligence’s post on LinkedIn, adding:

”Asundexian’s targeted Factor XIa inhibition offers potent antithrombotic protection with a differentiated safety profile (minimal impact on hemostasis), potentially transforming care for millions worldwide and could pave the way for broader, safer secondary stroke prevention strategies—if approved.”

Quoting Beyondsight Intelligence‘s post:

”Bayer’s Asundexian Cuts Stroke Risk by 26%, No increase in major bleeding in Phase 3

Bayer reported positive topline results from the Phase 3 OCEANIC-STROKE trial evaluating asundexian (50 mg), an investigational once-daily oral Factor XIa inhibitor.

Key Highlights:

• 26% reduction in recurrent stroke risk vs placebo
• Studied in patients with prior non-cardioembolic ischemic stroke or high-risk TIA
• Added on top of standard antiplatelet therapy
• No increase in ISTH major bleeding vs placebo
• Designed for effective thrombosis prevention with a wider safety margin

Why It Matters:

• Current antithrombotics often require a trade-off between efficacy and bleeding risk
• Factor XI inhibition is emerging as a next-generation anticoagulation strategy
• Could enable safer long-term secondary stroke prevention

Key Takeaway:

Asundexian’s Phase 3 results suggest meaningful stroke risk reduction without the usual bleeding penalty—potentially reshaping the future of antithrombotic therapy.

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News Source Demonstrated a Substantial Reduction in Stroke After a Non-Cardioembolic Ischemic Stroke or High-Risk Transient Ischemic Attack With No Increase in ISTH Major Bleeding Versus Placebo”

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