Emerging Factor XIa Inhibitor Therapy: Implications for Pharmacist-Led Stroke Prevention

This activity was originally presented at the 2026 Directions in Pharmacy (DIP) Conference.

Program Description

Stroke remains a leading cause of long-term disability and mortality. Despite advances in acute management and secondary prevention, many patients remain at high risk for recurrent events, which imposes a substantial clinical and economic burden on patients, caregivers, and health care systems. Standard-of-care antiplatelet strategies have proven to be beneficial but leave a persistent residual risk, with a significant number of patients experiencing another stroke within 90 days. Balancing antithrombotic efficacy against the risk of major bleeding continues to pose a challenge for clinicians and reinforces the need for alternative preventive options.

Emerging Factor XIa (FXIa) inhibitors represent a promising therapeutic approach by selectively targeting the coagulation pathway to prevent thrombosis while preserving normal hemostasis. As these therapies move closer to clinical implementation, pharmacists are ideally positioned within stroke management teams to support consistent application of stroke management guidelines, explain the clinical rationale for FXIa inhibition, and lead individualized approaches to stroke prevention. This session will review opportunities for pharmacists to identify patients at risk for recurrent stroke, apply guidelines and effectively use classification systems, and integrate evidence-based interventions through medication therapy management, patient counseling, and interdisciplinary collaboration to improve outcomes and reduce the burden of stroke.

Target audience: Community pharmacists and retail pharmacists
Type of activity: Application
Release date: June 30, 2026
Expiration date: June 30, 2027
Learner level: Foundational, Intermediate
Time to complete activity: 1.0 hour
Fee: Free

Educational Objectives

At the completion of this activity, pharmacists will be able to:

• Use knowledge of ischemic stroke and the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification to identify non-cardioembolic stroke types and choose evidence-based antithrombotic treatments for prevention
• Explain the coagulation cascade, including the rationale for why Factor XIa is targeted, as well as clinical data on investigational Factor XIa inhibitors, focusing on their efficacy and safety
• Demonstrate how pharmacists can improve antithrombotic care via medication therapy management, monitoring adherence, and patient education