Antithrombotic effect of antisense factor XI oligonucleotide treatment in primates.

Crosby JR, Marzec U, Revenko AS, Zhao C, Gao D, Matafonov A, Gailani D, MacLeod AR, Tucker EI, Gruber A, Hanson SR, Monia BP
Arterioscler Thromb Vasc Biol. 2013 33 (7): 1670-8

PMID: 23559626 · PMCID: PMC3717325 · DOI:10.1161/ATVBAHA.113.301282

OBJECTIVE - During coagulation, factor IX (FIX) is activated by 2 distinct mechanisms mediated by the active proteases of either FVIIa or FXIa. Both coagulation factors may contribute to thrombosis; FXI, however, plays only a limited role in the arrest of bleeding. Therefore, therapeutic targeting of FXI may produce an antithrombotic effect with relatively low hemostatic risk.

APPROACH AND RESULTS - We have reported that reducing FXI levels with FXI antisense oligonucleotides produces antithrombotic activity in mice, and that administration of FXI antisense oligonucleotides to primates decreases circulating FXI levels and activity in a dose-dependent and time-dependent manner. Here, we evaluated the relationship between FXI plasma levels and thrombogenicity in an established baboon model of thrombosis and hemostasis. In previous studies with this model, antibody-induced inhibition of FXI produced potent antithrombotic effects. In the present article, antisense oligonucleotides-mediated reduction of FXI plasma levels by ≥ 50% resulted in a demonstrable and sustained antithrombotic effect without an increased risk of bleeding.

CONCLUSIONS - These results indicate that reducing FXI levels using antisense oligonucleotides is a promising alternative to direct FXI inhibition, and that targeting FXI may be potentially safer than conventional antithrombotic therapies that can markedly impair primary hemostasis.

MeSH Terms (18)

Animals Antibodies, Monoclonal Arteriovenous Shunt, Surgical Bleeding Time Blood Coagulation Collagen Disease Models, Animal Dose-Response Relationship, Drug Down-Regulation Factor XI Fibrinolytic Agents Hemorrhage Macaca fascicularis Oligonucleotides, Antisense Papio Thrombin Thrombosis Time Factors

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