In vitro comparison of the effects of abelacimab, dalteparin, and apixaban on catheter-induced clotting and thrombin generation.

BACKGROUND

Abelacimab is a fully human monoclonal antibody that binds factor XI, blocking its activation and activity. It is being compared with apixaban and dalteparin in patients with cancer-associated venous thromboembolism. Patients with cancer often have central venous catheters, which are prone to clotting. How abelacimab compares with apixaban and dalteparin for preventing catheter thrombosis is unknown.

OBJECTIVES

The aim of this study was to compare the effects of abelacimab, apixaban, and dalteparin on the activated partial thromboplastin time (aPTT) and catheter-induced clotting and thrombin generation using an established plate-based catheter thrombosis model.

METHODS

The effect of abelacimab, apixaban, and dalteparin on the aPTT was determined. Human plasma containing abelacimab, apixaban, or dalteparin was added to wells of 96-well plates, with or without catheter segments. After incubation and recalcification, the time to clot formation and thrombin generation was measured.

RESULTS

All 3 anticoagulants prolonged the aPTT and suppressed catheter-induced clotting and thrombin generation in a concentration-dependent manner. At clinically relevant concentrations, dalteparin and abelacimab exerted more potent effects on the aPTT, catheter-induced clotting, and thrombin generation than apixaban.

CONCLUSION

Abelacimab and dalteparin suppress catheter-induced clotting more effectively than apixaban. Clinical trials are needed to determine whether abelacimab prevents catheter-induced clotting in patients with cancer.