DOAC-Stop Reversal of FXIa Inhibitors
Bibliographic record
Abstract
Factor (F) XI is a serine protease involved in the intrinsic pathway of coagulation. This protein is an emerging target for anticoagulation due to its presumed minor role in hemostasis, but major role in thrombosis. FXI and activated FXI (FXIa) inhibitors are promising alternatives to traditional anticoagulants like vitamin K antagonists and heparins, and newer therapies like direct oral anticoagulants (DOACs), which target thrombin or FXa. Coagulation tests, like the activated partial thromboplastin time (APTT), are critical for evaluating the clotting pathways. Notably, the APTT is used to diagnose antiphospholipid syndrome (APS), which is an autoimmune disease that increases the risk of thrombosis. Since DOACs selectively inhibit coagulation, they prolong the APTT and can potentially mimic patterns characteristic of an underlying coagulation disorder like APS. As a consequence, in patients receiving DOAC therapy, it becomes challenging to distinguish between the inhibitory effects of DOACs and indicators of a pathological condition. Current strategies to address DOAC interference have significant disadvantages. DOAC-Stop™ (DS) is an activated charcoal-based compound that adsorbs molecules such as DOACs. Studies show that DS reverses the effects of dabigatran, apixaban, edoxaban, and rivaroxaban on the APTT. However, it remains unknown whether DS is capable of reversing the effects of new FXI(a) inhibitors. This thesis aims to determine whether DS reverses the effects of asundexian, milvexian, and abelacimab on the APTT. We first establish that the FXI(a) inhibitors prolong the APTT. We then show that DS reverses the effects of asundexian and milvexian on the APTT, but not abelacimab. Additionally, we show that DS distinguishes between the effects of milvexian and heparin. These findings suggest that DS may serve as a potential method to reverse the effects of asundexian and milvexian on the APTT and to distinguish their effects from that of heparin.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".