SynthesisBrain and behavior2026
Oral Factor XIa Inhibitors for Secondary Prevention After Noncardioembolic Ischemic Stroke or High-Risk Transient Ischemic Attack: Systematic Review and Meta-Analysis.
Synthesis in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with recent noncardioembolic ischemic stroke or high-risk transient ischemic attack (TIA) remain at risk of recurrent events despite antiplatelet therapy. Oral factor XIa (FXIa) inhibitors may reduce thrombotic risk while limiting bleeding, but their adjunctive efficacy and safety require clarification.
methodsPubMed, Embase, Cochrane Library/CENTRAL, and ClinicalTrials.gov were searched through May 2026 for randomized, double-blind, placebo-controlled trials of oral FXIa inhibitors added to antiplatelet therapy. Primary efficacy and safety outcomes were recurrent ischemic stroke and major bleeding. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models.
resultsThree trials randomized 16,501 participants overall, of whom 14,239 contributed to the primary selected-dose efficacy analysis. FXIa inhibition reduced recurrent ischemic stroke (413/6927 vs. 579/7312; RR 0.74, 95% CI 0.65-0.84; I
conclusionsIn patients with recent noncardioembolic ischemic stroke or high-risk TIA receiving antiplatelet therapy, pooled randomized evidence showed a reduction in recurrent ischemic stroke with oral FXIa inhibition; however, the estimate was predominantly driven by the phase 3 asundexian trial, limiting certainty regarding generalization across individual FXIa inhibitors. Major bleeding and other safety outcomes were not significantly increased, although rare-event estimates were imprecise and clinically important harm cannot be excluded.
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