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Anivamersen is a synthetic antisense oligonucleotide developed as part of the REG1 anticoagulation system, which also includes pegnivacogin. Anivamersen acts as a reversal agent for pegnivacogin, a nucleotide aptamer that inhibits coagulation factor IXa. By binding to pegnivacogin through Watson–Crick base pairing, anivamersen neutralizes its anticoagulant effect within minutes after intravenous administration. The resulting complex is biologically inert and cleared via nuclease-mediated degradation. The REG1 system was investigated primarily for use in patients undergoing percutaneous coronary intervention (PCI) and for the treatment of acute coronary syndrome and venous thrombosis[6][7][8]. Development was discontinued after phase 3 trials.
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