What drugs are in the Factor XI / XIa inhibitors class?

12 active programs in the Factor XI / XIa inhibitors class are tracked in this platform view (19 listed in all, with those that have no recent activity shown separately), including cenvacibart, milvexian, and amrecibart. The heatmap maps every drug against the indications it is being developed for.

What conditions are Factor XI / XIa inhibitors being developed for?

Factor XI / XIa inhibitors are in clinical development across 9 indications, including Atrial Fibrillation, Venous Thromboembolism, Kidney Failure on Dialysis, Catheter-Related Thrombosis, and Stroke (secondary prevention).

How many Factor XI / XIa inhibitors are in late-stage trials?

Of the 12 tracked assets in the Factor XI / XIa inhibitors class, 5 are at Phase 3 or later, developed by 10 sponsors, across 76 mapped trials.

What are the upcoming Factor XI / XIa inhibitors catalysts?

Near-term catalysts in this class include milvexian (data readout, Oct '26); milvexian (data readout, Dec '26); KN060 (data readout, Dec '26). Dates combine estimated trial readouts and confirmed FDA decision dates.

Dashboards / Mechanism heatmaps

Page updated Nov 13, 2026 · using data updated on Nov 12, 2026

Factor XI Inhibitors in Development

Factor XI / XIa inhibitors · drug platform heatmap

What are factor XI inhibitors?

Factor XI inhibitors are blood thinners (anticoagulants) that block clotting factor XI or its active form, factor XIa. People born with factor XI deficiency usually bleed only after injury or surgery, yet have fewer ischemic strokes than expected, which suggested that blocking factor XI could prevent clots with less bleeding than current blood thinners. The first, asundexian (Sunharbo), was approved by the FDA on November 9, 2026.

Factor XI inhibitors in clinical trials in 2026

TheraRadar tracks 12 factor XI inhibitors with recent clinical activity (1 approved) in 76 registered trials, and 5 have reached Phase 3 or later. Among them are asundexian (Bayer, approved), milvexian (Johnson & Johnson), cenvacibart (Regeneron) and amrecibart (Regeneron). Venous thromboembolism has the most factor XI inhibitors in trials (7), followed by atrial fibrillation (6) and kidney failure on dialysis (5). The next Phase 3 readouts, by the estimated completion date on ClinicalTrials.gov: milvexian (LIBREXIA-AF, Dec 2026), cenvacibart (ROXI-APEX, Feb 2027) and abelacimab (LILAC-TIMI 76, Dec 2027).

12 active programs

9 indications

76 trials

5 at Phase 3 or later

10 sponsors

Targets: Factor XI · Factor XIa · Factor XI / XIa

Beta 10 programs 9 indications 33 programs mapped curated roster · no per-cell AI classification ⏰ 6 due ≤6 mo click any cell → asset tearsheet

At a glance

10 programs in this class span 9 indications (33 drug–indication pairs mapped). The most contested indication is Atrial Fibrillation (13 programs).

Forward catalysts next 18 months⏰ 6 due ≤6 mo

Nearest first. ⚖ Confirmed FDA PDUFA dates (curated calendar, primary sources) and 📅 estimated readouts (ClinicalTrials.gov primaryCompletionDate — a timing proxy, not a confirmed action date). Red = due within 6 months.

Drug × Indication

Each cell = this program’s trials in that indication. Click for details.

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	Atrial Fibrillation	Venous Thromboembolism	Kidney Failure on Dialysis	Catheter-Related Thrombosis	Stroke (secondary prevention)	Peripheral Artery Disease	Coronary Artery Disease	Acute Coronary Syndrome	Hypertension
cenvacibartRegeneronFactor XI
milvexianJohnson & JohnsonFactor XIa
amrecibartRegeneronFactor XI
abelacimabNovartisFactor XI
asundexianBayerFactor XIa
KN060Suzhou AlphamabFactor XI / XIa
gruticibartAronoraFactor XI
vortosiranRibocure PharmaceuticalsFactor XI
SRSD107Sirius TherapeuticsFactor XI
RBD1119Ribocure PharmaceuticalsFactor XI

Beyond the grid Beta

What the matrix leaves out — rare mechanisms with only one player, small & emerging sponsors, and programs we haven’t classified yet.

White-space indications — a single asset 1 found

Indications where only ONE asset in this family competes — uncrowded ground for a new entrant.

⚡ first-in-class · 🌱 first-in-indication · 🆕 NME candidate · ✅ AI-classified + verified · ⚙️ AI-classified, unverified · first-in-class computed across 1 mapped landscape

Active programs — indication not yet mapped (2) — in-scope assets whose trials we haven’t yet resolved to an indication column

Phase	Mechanism	Company	Modality	Readout	Trial
Phase 1	CITY-FXI — Factor XIunclassified	City Therapeutics		1Q28	NCT07430397
Phase 1	FXI-GalNAc-siRNA — Factor XIunclassified	Sirnaomics		⏰ 2Q27	NCT05844293

Small-molecule factor XIa inhibitors

2 active programs, most advanced first.

Drug	Targets	Sponsor	Phase	Main indications	Trials
asundexian	Factor XIa	Bayer	Approved fda.gov pubmed.ncbi.nlm.nih.gov	Stroke (secondary prevention) · Atrial Fibrillation · Acute Coronary Syndrome	7
milvexian	Factor XIa	Johnson & Johnson Janssen Research & Development is the registry sponsor; Bristol Myers Squibb is listed as collaborator and co-funder.	Phase 3 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Stroke (secondary prevention) · Kidney Failure on Dialysis · Atrial Fibrillation	26

Antibodies against factor XI

5 active programs, most advanced first.

Drug	Targets	Sponsor	Phase	Main indications	Trials
abelacimab	Factor XI	Novartis Developed by Anthos Therapeutics, which Novartis acquired in 2025 (Novartis results filing). Anthos remains the registry sponsor of the core trials.	Phase 3 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Atrial Fibrillation · Venous Thromboembolism	6
amrecibart	Factor XI	Regeneron	Phase 3 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Atrial Fibrillation · Catheter-Related Thrombosis · Peripheral Artery Disease	9
cenvacibart	Factor XI	Regeneron	Phase 3 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Venous Thromboembolism · Atrial Fibrillation · Catheter-Related Thrombosis	16
gruticibart	Factor XI	Aronora	Phase 2 clinicaltrials.gov	Catheter-Related Thrombosis · Kidney Failure on Dialysis	4
KN060	Factor XI / XIa	Suzhou Alphamab	Phase 2 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Kidney Failure on Dialysis · Venous Thromboembolism · Hypertension	3

RNA drugs that lower factor XI

5 active programs, most advanced first.

Drug	Targets	Sponsor	Phase	Main indications	Trials
RBD1119	Factor XI	Ribocure Pharmaceuticals	Phase 2 clinicaltrials.gov	Coronary Artery Disease	2
SRSD107	Factor XI	Sirius Therapeutics	Phase 2 clinicaltrials.gov clinicaltrials.gov	Coronary Artery Disease · Peripheral Artery Disease · Venous Thromboembolism	4
vortosiran	Factor XI	Ribocure Pharmaceuticals	Phase 2 pubmed.ncbi.nlm.nih.gov clinicaltrials.gov	Venous Thromboembolism · Atrial Fibrillation · Coronary Artery Disease	4
CITY-FXI	Factor XI	City Therapeutics	Phase 1 clinicaltrials.gov		1
FXI-GalNAc-siRNA	Factor XI	Sirnaomics	Phase 1 clinicaltrials.gov		1

No recent activity

Programs whose trials ended or went quiet without an announced decision. Their status is unknown, not necessarily stopped.

Drug	Targets	Sponsor	Status
frunexian	Factor XIa	eXIthera Pharmaceuticals	Its Phase 2, in continuous renal replacement therapy (NCT05602129, Haisco), has an unknown registry status and was last updated in 2022. A COVID-19 Phase 2 (NCT05040776) was withdrawn before enrolling.
SHR2285	Factor XIa	Jiangsu Hengrui	Its only Phase 2 (NCT05203705) was terminated; the registry reason is "Adjustment of the sponsor's R&D strategy". No active trial on ClinicalTrials.gov as of 2026-11-13.
ONO-7684	Factor XIa	Ono Pharmaceutical	No active trial on ClinicalTrials.gov as of 2026-11-12.
SHR-2004	Factor XI	Beijing Suncadia Pharmaceuticals	Phase 3 after knee replacement (NCT06825416, China) is completed with no results posted. No active trial on ClinicalTrials.gov as of 2026-11-12.
osocimab	Factor XIa	Bayer	No active trial on ClinicalTrials.gov as of 2026-11-12.
MK-2060	Factor XI	Merck	No active trial on ClinicalTrials.gov as of 2026-11-12.
fesomersen	Factor XI	Bayer	No active trial on ClinicalTrials.gov as of 2026-11-12.

How this list was built

Programs were identified by searching ClinicalTrials.gov by drug name, code name and class, and each has at least one primary source: a paper, the FDA announcement, or the drug's own registry record. Trials are matched to a program by exact drug name or code. Drugs whose records do not state the target are left out, so early programs are probably undercounted. Trials whose registry status is unknown or withdrawn are not shown. Indications are the clinical setting each trial was run in, set from its registry conditions and title.

Frequently asked

Common questions about the Factor XI / XIa inhibitors landscape

What drugs are in the Factor XI / XIa inhibitors class?: 12 active programs in the Factor XI / XIa inhibitors class are tracked in this platform view (19 listed in all, with those that have no recent activity shown separately), including cenvacibart, milvexian, and amrecibart. The heatmap maps every drug against the indications it is being developed for.
What conditions are Factor XI / XIa inhibitors being developed for?: Factor XI / XIa inhibitors are in clinical development across 9 indications, including Atrial Fibrillation, Venous Thromboembolism, Kidney Failure on Dialysis, Catheter-Related Thrombosis, and Stroke (secondary prevention).
How many Factor XI / XIa inhibitors are in late-stage trials?: Of the 12 tracked assets in the Factor XI / XIa inhibitors class, 5 are at Phase 3 or later, developed by 10 sponsors, across 76 mapped trials.
What are the upcoming Factor XI / XIa inhibitors catalysts?: Near-term catalysts in this class include milvexian (data readout, Oct '26); milvexian (data readout, Dec '26); KN060 (data readout, Dec '26). Dates combine estimated trial readouts and confirmed FDA decision dates.
How is the Factor XI / XIa inhibitors platform compiled?: Programs were identified by searching ClinicalTrials.gov by drug name, code name and class, and each has at least one primary source: a paper, the FDA announcement, or the drug's own registry record. Trials are matched to a program by exact drug name or code. Drugs whose records do not state the target are left out, so early programs are probably undercounted. Trials whose registry status is unknown or withdrawn are not shown. Indications are the clinical setting each trial was run in, set from its registry conditions and title. Each cell links to the underlying trial records.
Is the Factor XI / XIa inhibitors heatmap free to use?: Yes — viewing and searching the Factor XI / XIa inhibitors heatmap is free. A TheraRadar Pro subscription adds advanced filters, row/column selection, and one-click export to PowerPoint, PDF, and CSV.

Data: ClinicalTrials.gov · Curated program roster · Trials registered 2008 onwards.