Good evening, everyone. Welcome. Welcome. It's wonderful to have all of you here at this spotlight session at ACC25. Hopefully, everyone's had a chance to get a little bit of food in the back. You've got a drink, and sitting down, you're ready to go. We're going to spend the next hour and a half really diving into some anticoagulation and thinking about what's sort of on the horizon, these factor 11 inhibitors. Hopefully, you're in the right session. I know you've got the best food here, and we've got the best panelists. You're ready for a treat. I'd like to introduce myself. My name is Jeffrey Barnes. I'm from the University of Michigan. I'm going to be moderating this session today. And I'm thrilled to be joined by just four wonderful panelists who are going to participate in our conversation and discussion and do some teaching. So I'm actually going to ask each of them to go ahead and introduce themselves as we go down the room. So Bob, do you want to start? Yes. Good evening. My name's Bob Harrington from Weill Cornell Medicine in New York City. And maybe for the purposes of this, with disclosure, I'm the executive committee chair for the three trials being done with milvexian. Hi, everyone. I'm Kristen Bove Campbell. I am a clinical pharmacist at Duke University Hospital. I'm Jean Connors. I'm a hematologist at Brigham and Women's Hospital and Dana-Farber Cancer Institute in Boston and Harvard Medical School. I'm Mark Bernanke. I'm a cardiologist and vascular medicine physician, director of vascular research at the University of Colorado School of Medicine. Well, great. We are going to be learning a lot from all of our panelists. We're going to have some great discussion this evening. You're all here for this session. And I want to acknowledge and thank the Bristol-Myers Squibb and Janssen Pharmaceutical Alliance who have supported this through an educational grant for this clinical spotlight series. All of you, as you came in the room, your ID badges were scanned. So you will be getting an email by April 1 that will allow you to claim credit. You'll have to answer a couple questions for us in order to claim credit for being a part of this. You can also go to the website that you see on the screen in case you don't get that email. But that's a great way to claim the credit. And we'll go ahead and send that off for you. But more importantly for tonight, we're going to be using that audience response system. So I'd really like everyone to go ahead and get out your phone. Or if you have an iPad or some other device, go ahead and get that out. Scan this QR code. This is going to bring up our audience response system so that you guys can all participate. So I see everyone's got those phones out. Folks are scanning. If anyone's running into any issues, raise your hand. We've got a couple of staff in the back who can come over and help you get that going. But we're going to have you really use these phones because we're going to ask a bunch of questions. And in fact, I'd like to start off with five questions to really get us in the groove, sort of figure out what we already know about sort of anticoagulants and these factor XI inhibitors. So everyone's got their phone out. We're going to go ahead and get started with a couple of our pre-session questions. So I'll read the first one to you, and then it'll pop up. Which of the following factor XI and or XIa inhibitors has a rapid onset and a short half-life, something that's measured in terms of hours? Is it going to be abalasamab, fesamercin, milvexian, or ososamab? So think about those four options. I'm going to pull up our polling system here. And go ahead, enter in your answers. A for abalasamab, B for fesamercin, C for milvexian, D for ososamab. Again, rapid onset, short half-life. That's what we're looking for here. OK, great. Great, thank you guys. OK, we're going to move on to question number two. Question number two, which of the following statements is true regarding inhibition of factor XI or XIa in patients who are undergoing orthopedic knee arthroplasty? So A, are there lower rates of bleeding, but similar rates of thrombosis as a low molecular weight heparin? Is it B, that we have lower rates of bleeding, but higher rates of thrombosis as low molecular weight heparin? Is it C, that there are similar rates of bleeding, but higher rates of thrombosis as that low molecular weight heparin? Or D, do we have similar or lower rates of bleeding with lower rates of thrombosis as low molecular weight heparin? So let's go ahead and lock in those answers. What do we think about sort of the class as a whole, factor XI, XIa inhibitors in the orthopedic knee arthroplasty patient? How do we compare to bleeding and thrombosis versus a low molecular weight heparin agent? OK, great. Hopefully, everyone got in their answers. Two down, three more to go. Let's move on to question number three here. Which of the following agents indirectly targets the common pathway of the clotting cascade? Now, I know there's mostly cardiovascular specialists here, and sometimes that clotting cascade can give us a little bit of heartburn, right? Gene's going to work us through it, so don't worry. But which of these is an indirect way to target the common pathway? Is it apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin? So go ahead and lock in those answer choices here. Everyone's working through, thinking about these different drugs and what their mechanisms are, figuring out which one's that indirect common pathway inhibitor. OK, great, great. We are over halfway done, guys. You're doing a great job. Let's move on to question number four. So as we think about the current phase III clinical trials, the factor XI, XI As, which of the following conditions is not currently involved in a phase III clinical trial? Is it acute coronary syndrome, atrial fibrillation, cancer-associated venous thromboembolism treatment, prevention of venous thromboembolism after an orthopedic surgery, or secondary stroke prevention in patients without atrial fibrillation? So which of these is not currently undergoing phase III clinical trials with a factor XI, XI A inhibitor? So you've got five choices there. Pick the one that's not currently in phase III trials. OK, we've got those answers. Two seconds to enter them in. OK, great, great. We've got one more question for everyone, OK? Question number five here. Which of these is an evidence-based strategy that helps us improve the safe use of oral anticoagulant medications? Is it the implementation of a prior authorization process for outpatient prescribing, something I know all of us just love dearly? Is it the implementation of multidisciplinary anticoagulation stewardship programs? Is it renal function testing every three months? Or is it screening for anemia prior to prescribing an anticoagulant? So which of these is an evidence-based strategy that improves the safe use of oral anticoagulant medications? Go ahead and look at those choices and pick which one you think is the right answer. Lots of different things you can do. Some we like more. Some maybe give us a little more trouble. But there's one right answer there, I promise. OK, great. We're going to go through and talk about a lot of those as we run through the session this evening. Thank you, guys. Hopefully, everyone feels comfortable using that audience response system now, because we're going to use that throughout the rest of the presentation. But what we're going to do here is get ourselves started. So this is really going to be the knockout round. We're sort of modeling this after a big heavyweight fight. We've got some boxers up here. We've got the themes going. What I want you guys to do is to think about the team battle. Which of our teams is going to win our big battle for this evening, OK? We're going to be using those audience response question systems that you guys just used to earn points and to figure out which of our teams knocks it out of the park when it comes to their knowledge around anticoagulants and factor XI's. So here's the way it's going to work. If you guys look on your table, each of you should have the name of a famous boxer, right? We've got a couple of different groups there. Make sure you've scanned that code. And what's going to happen on your audience response system is you're going to get a chance to pull down and select which of the boxers you're fighting for, OK? So which of the different teams? Any time we go through our presentation and you hear that bell, that means we're going to be pulling up an audience response question. We want you to get your phone ready. Correct answers, quickly answered, are going to earn your team the most points. So the quicker you answer, and make sure it's a correct answer, that's how you're going to get your team the most points. And we'll sort of track things throughout the course of the evening, OK? At the end of the night, we'll figure out which of our teams gets this championship belt that we've got down here. So that'll be a fun prize for one of our teams to walk away with. So we've got five different teams, OK? We've got the Muhammad Ali team. Who's on the Muhammad Ali team? Raise your hand if you're at a Muhammad Ali team. OK, good. I think we've got a strong team there. We've got some Joe Lewis team members. Who are our Joe Lewis team members? OK, I see a couple spread out through here. Yep, and in the back. That's good. Who are our Vander Holyfield team members? Ah, yeah, I see a couple of you guys. Great. OK, OK, good. Who's our Lennox Lewis team? Oh, that might be the team to beat. That's going to be a good one there. I like that. And of course, you can't have a boxing competition without Mike Tyson. Where are Mike Tyson team members? Oh, yes, lots of enthusiasm there over here, too. OK. So remember, when you hear that ding, you're going to pull up those phones, get ready for that audience response question, OK?

Factor XI inhibitors

anticoagulation

interactive discussion

clinical applications

professional credits