Safety of Factor XI Inhibition With Abelacimab in Atrial Fibrillation by Kidney Function

In patients with atrial fibrillation (AF), does the safety of abelacimab (a novel factor XI inhibitor) relative to rivaroxaban differ by kidney function?In this secondary analysis of the AZALEA-TIMI 71 randomized clinical trial, among patients allocated to rivaroxaban, those with reduced creatinine clearance had approximately 2-fold higher rates of bleeding, despite rivaroxaban dose reduction, compared with those with a higher creatinine clearance. Abelacimab reduced major or clinically relevant nonmajor bleeding vs rivaroxaban, irrespective of kidney function.Abelacimab, if proven effective for stroke prevention in AF, may be particularly advantageous to reduce bleeding in patients with kidney impairment.

Corresponding Author: Siddharth M. Patel, MD, MPH, Brigham and Women's Hospital, 60 Fenwood Rd, Ste 7022, Boston, MA 02115 (spatel@bwh.harvard.edu).

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