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Xisomab 3G3 (also known as AB023) is a humanized IgG4 monoclonal antibody that targets the apple 2 domain of coagulation factor XI (FXI). By binding to FXI, it prevents its activation by factor XIIa (FXIIa), thereby inhibiting the contact activation pathway of coagulation. This mechanism reduces pathological thrombosis risk without significantly affecting normal hemostasis, as it does not interfere with FXI feedback activation by thrombin or other vasoregulatory activities. Xisomab 3G3 is being developed primarily for the prevention of catheter-associated thrombosis and for use in patients with end-stage renal disease on chronic hemodialysis who are at high risk for both thrombosis and bleeding. The drug has demonstrated a favorable safety profile in early clinical trials, showing no increased bleeding risk and effective reduction in device-associated clotting events[1][2][5][6][7].
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