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The holy grail of anticoagulant therapy is inhibiting thrombosis without impairing hemostasis. All currently available antithrombotic agents are associated with an increase in hemorrhagic events, but new drugs under investigation might provide anticoagulation without increasing bleeding risks.
A new review discusses experimental evidence that certain thrombotic targets might be safely inhibited. For example, factor XI levels can be reduced by an antisense oligonucleotide, decreasing postoperative venous thromboembolism in patients undergoing knee arthroplasty without increasing bleeding (NEJM JW Oncol Hematol Feb 2015 and N Engl J Med 2015; 372:232). In addition, hemostasis appears to be intact in mice that have genetic defects in certain pl…