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reltodecacog alfa (VMX-C001) is a modified recombinant human coagulation factor X (FX) zymogen being developed as a bypassing agent to restore blood coagulation in patients taking direct oral factor Xa (FXa) inhibitors (such as apixaban, rivaroxaban, and edoxaban) who experience severe bleeding or require urgent surgery. Developed by VarmX (a spin-off from Leiden University Medical Center) in collaboration with CSL, the protein is engineered with a modified sequence (inspired by snake venom) that renders it insensitive to inhibition by FXa direct oral anticoagulants (DOACs) while retaining its ability to be activated and participate in the coagulation cascade to generate thrombin.
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