← Kelly Casteel, MD
Clinical Reference · Anticoagulant Development Arc

The Anticoagulation Arc — Heparin to Factor XI

A century of trading thromboembolic risk against bleeding. Every advance on this timeline is an attempt to widen the therapeutic window — from antithrombin-dependent parenteral agents through the DOAC era to factor XI/XIIa inhibitors engineered to decouple thrombosis from hemostasis. Click any node for the full trial lineage, regulatory history, and reversal pathway.

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Indication
The net clinical benefit problem
As agents improved, modelled population thromboembolic risk fell — yet major bleeding has remained a stubborn constraint. The frontier (factor XI) aims to bend the bleeding line down without sacrificing efficacy.
Thromboembolic risk Major bleeding
↔ Scroll horizontally to traverse the timeline · click a node to open its trial card
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