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JNJ-64179375 (also known as JNJ-9375 and ichorcumab) is a first-in-class, recombinant, fully human IgG4 monoclonal antibody that acts as an anticoagulant by binding with high affinity and specificity to exosite 1 on thrombin. This selective inhibition blocks exosite 1-mediated fibrinogen binding to thrombin (and also proteinase-activated receptor-1 binding), but does not inhibit the catalytic activity of thrombin or its exosite 2 functions. The drug was engineered to mimic an IgA antibody found in a patient with prolonged clotting times but no abnormal bleeding episodes. Its mechanism offers the potential for effective antithrombotic therapy with reduced bleeding risk compared to conventional direct thrombin inhibitors. It has been investigated primarily for prevention of venous thromboembolism (VTE) after total knee replacement surgery[1][2][3][4][5][6][8].
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