Milvexian for the Prevention of Venous Thromboembolism

This phase 2 randomized trial evaluated the efficacy and safety of milvexian, an oral Factor XIa inhibitor, for preventing venous thromboembolism in 1242 patients undergoing knee arthroplasty. Participants were assigned to various dosing regimens of milvexian or to standard enoxaparin. Milvexian demonstrated a dose-dependent reduction in thrombosis incidence, with rates as low as 8% in the highest-dose group versus 21% for enoxaparin. Bleeding risks remained comparable and low across all groups. The results support milvexian’s potential as a safe, effective oral anticoagulant for postoperative thromboprophylaxis.

This phase 2 randomized trial evaluated the efficacy and safety of milvexian, an oral Factor XIa inhibitor, for preventing venous thromboembolism in 1242 patients undergoing knee arthroplasty. Participants were assigned to various dosing regimens of milvexian or to standard enoxaparin. Milvexian demonstrated a dose-dependent reduction in thrombosis incidence, with rates as low as 8% in the highest-dose group versus 21% for enoxaparin. Bleeding risks remained comparable and low across all groups. The results support milvexian’s potential as a safe, effective oral anticoagulant for postoperative thromboprophylaxis.