Factor XI inhibitors: is it time for a paradigm shift in anticoagulation?

Factor XI (FXI) is one of the components of the coagulation cascade, connecting its intrinsic and common pathway. FXI inhibitors have emerged in these few years as interesting therapeutic drugs, with potential advantages over standard anticoagulants in terms of lowering thrombotic risk and limiting bleeding consequences. Better knowledge of the underlying processes of thrombosis led to the design of several clinical trials based on the inhibition of this factor. The discovery of molecules, antibodies, and antisense oligonucleotides capable of binding to this factor is paving the way for new anticoagulation strategies, which will be analyzed in this review.