Asundexian Prevents Secondary Stroke in Addition to Standard Antiplatelet Therapy

Background: Patients with an ischemic stroke or transient ischemic attack (TIA) have a 5.1% incidence of recurrent stroke within a year despite treatment such as single or dual antiplatelet therapy, which is associated with an increased risk of bleeding. Factor XI is a component of the intrinsic coagulation pathway, and reduced levels are associated with lower stroke risk. Objective: To evaluate the efficacy and safety of asundexian, an inhibitor of activated factor XI, for secondary stroke prevention in patients with ischemic stroke or high-risk TIA. Design: Phase 3, multicenter, international, double-blind, event-driven, randomized placebo-controlled (OCEANIC-STROKE) trial. Participants: Eligible patients were aged ≥18 years with a noncardioembolic ischemic stroke or high-risk TIA within 72 hours of symptoms with planned treatment with antiplatelet therapy. Patients with stroke were limited to a maximum National Institutes of Health Stroke Scale (NIHSS) score of 15, and high-ris more...