Name
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example@example.com
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MD
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How many patients do you currently see each month regarding atrial fibrillation?
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How many years have you been in practice?
1. What is the primary therapeutic rationale for targeting Factor XI (FXI) or FXIa as a novel anticoagulation strategy in clinical trials?
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a. To achieve more potent inhibition of the initiation phase of the coagulation cascade than Vitamin K Antagonists (VKAs).
b. To uncouple pathological thrombosis from physiological hemostasis by targeting the amplification loop of the coagulation cascade.
c. To provide a faster-acting alternative to dual antiplatelet therapy (DAPT) for patients with acute myocardial infarction.
d. To eliminate the need for Thrombin (FIIa) generation during the consolidation phase of clot formation.
2. In the OCEANIC-AF Trial, what was a key finding regarding the use of asundexian 50 mg daily for stroke prevention in patients with atrial fibrillation?
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a. Asundexian demonstrated a significant reduction in myocardial infarction, stroke, and systemic embolism compared to apixaban.
b. Asundexian achieved 99% inhibition of free Factor XI activity, leading to the early termination of the trial for overwhelming efficacy.
c. Asundexian was associated with a higher incidence of stroke or systemic embolism compared to apixaban
d. The trial was discontinued because asundexian caused significantly higher rates of major bleeding compared to Vitamin K Antagonists.
3. Which statement best reflects the ALONE-AF Trial?
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a. It proved that all post-ablation AF patients can safely stop OAC
b. It randomized recurrence-free patients ≥1 year after ablation to stop vs continue OAC and found fewer composite events with discontinuation
c. It compared rivaroxaban with aspirin after ablation
d. It tested WATCHMAN FLX versus DOAC therapy
4. Which trial most directly tested whether LAAO can substitute for OAC in patients undergoing AF ablation?
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a. CHAMPION-AF
b. OPTION
c. OCEANIC-AF
d. LILAC-TIMI 76
5. Which ongoing phase 3 trial is placebo-controlled and enrolls AF patients deemed unsuitable for oral anticoagulation?
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a. LIBREXIA-AF
b. OCEANIC-AF
c. LILAC-TIMI 76
d. OPTION
c. OCEANIC-AF
d. LILAC-TIMI 76
Learning Objectives
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Describe the biologic and mechanistic rationale for targeting factor XI/XIa in SPAF, and contrast FXI/XIa directed strategies with current factor Xa based DOAC therapy
Differentiate mechanistic approaches to FXI pathway modulation—including zymogen level inhibition with a monoclonal antibody and active site inhibition with oral small molecule FXIa inhibitors—and discuss how these differences may translate into distinct clinical profiles
Evaluate the design, populations, and key endpoints of LIBREXIA AF and LILAC TIMI 76 in the context of prior FXI/XIa inhibitor trials (including OCEANIC AF) to assess how these ongoing Phase 3 programs test the FXI/XIa hypothesis in AF
Assess how potential efficacy and bleeding outcomes across FXI/XIa inhibitor programs could influence guideline recommendations; risk–benefit discussions; anticoagulant selection in diverse AF patient populations, including those unsuitable for current DOACs; current electrophysiology and AF clinic workflows; shared decision making in SPAF; and coordination across multidisciplinary care teams
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This educational activity will result in a change in my role as a healthcare team member.
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Based on your participation in this activity, choose the statement(s) that applies to how your role as a healthcare team member will change:
I gained new strategies/skills/information that my team can apply to practice
I plan to implement new strategies/skills/information in my practice
I will be more competent in my team’s management of patient care
I will improve my communication with the healthcare team
What factors beyond clinical care that effect the health of your patients does your team experience?
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