Educational Series on Vascular Risk


Two Factor XI Antibodies For the Prevention of Post- operative VTE: Results from ROXI-VTE-I and ROXI-VTE-II Trials

Key Points:

  • ROXI-VTE-I and ROXI-VTE-II evaluated two distinct factor XI monoclonal antibodies REGN9933A2 and REGN7508Cat, for prevention of venous thromboembolism (VTE) after elective knee replacement.
  • The Apple II domain-binding antibody (REGN9933A2) blocks factor XI activation by factor XIIa, while the catalytic domain-binding antibody (REGN7508 Cat) inhibits activation by both factor XIIa and thrombin.
  • REGN7508Cat was superior to enoxaparin for venous thromboembolism prevention; REGN9933A2 was not superior to enoxaparin. The findings with REGN7508Cat confirm the role of FXI in postoperative venous thromboembolism, and the findings with REGN9933A2 suggest that factor XIIa-driven factor XI activation contributes to this process.

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