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Reduced levels of clotting factor XI might offer protection against venous thromboembolism (VTE) and are generally associated with only a mild bleeding tendency. A specific antisense oligonucleotide (FXI-ASO) has been developed that decreases factor XI messenger RNA expression in the liver.
To determine if FXI-ASO decreases VTE in patients undergoing total-knee arthroplasty, investigators conducted a multicenter, randomized, open-label, phase II trial in which 72 patients received enoxaparin (40 mg once daily for ≥8 days), 144 patients received 200-mg doses of FXI-ASO, and 77 patients received 300-mg doses of FXI-ASO. FXI-ASO doses were given subcutaneously 3 or 4 times weekly beginning 36 days prior to surgery, were held during the week bef…