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Milvexian is an investigational, oral, small-molecule inhibitor of activated coagulation factor XI (Factor XIa), currently being co-developed by Bristol Myers Squibb and Janssen. It is designed to prevent and treat various thromboembolic conditions, including stroke, systemic embolism, and acute coronary syndrome. By targeting Factor XIa, milvexian inhibits the intrinsic pathway of the coagulation cascade, which is thought to play a significant role in pathological thrombus growth while having a minimal impact on hemostasis. This unique mechanism aims to provide effective anticoagulation with a significantly lower risk of clinically relevant bleeding compared to existing direct oral anticoagulants (DOACs) that target Factor Xa or thrombin.
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