Emerging anticoagulants with different mechanisms (e.g., Factor XI/XIa inhibitors, Factor XII/XIIa inhibitors) are in clinical testing and may come to market soon. The ISTH Control of Anticoagulation Scientific and Standardization Committee assembled a multi-disciplinary and diverse panel of global experts to propose a nomenclature scheme for this next phase of antithrombotic agents. By developing a nomenclature scheme before these agents come to market and by seeking comment and feedback from diverse stakeholders, our goal is to establish a terminology that is clear and will be well-accepted by the medical community.
Our recommendations are as follows:
- Describe anticoagulant medications by their specific target and mode of administration (e.g., oral Factor XIa inhibitor, parenteral Factor XIIa inhibitor).
- Factor XI/XIa and Factor XII/XIIa medications should not be included in the group of “direct oral anticoagulants (DOACs)” given their heterogenous mode of administration, targets (e.g., Factor XI, Factor XIa), mechanisms of action, unique impact on thrombosis/hemostasis, and likely distinct clinical uses in comparison to the oral Factor Xa and direct thrombin inhibitors.
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