Factor XIa (FXIa) is a blood coagulation enzyme that is involved in the amplification of thrombin generation. Mounting evidence suggests that direct inhibition of FXIa can block pathologic thrombus formation while preserving normal hemostasis. Preclinical studies using a variety of approaches to reduce FXIa activity, including direct inhibitors of FXIa, have demonstrated good antithrombotic efficacy without increasing bleeding. On the basis of this potential, we targeted our efforts at identifying potent inhibitors of FXIa with a focus on discovering an acute antithrombotic agent for use in a hospital setting. Herein we describe the discovery of a potent FXIa clinical candidate, 55 (FXIa K_i = 0.7 nM), with excellent preclinical efficacy in thrombosis models and aqueous solubility suitable for intravenous administration. BMS-962212 is a reversible, direct, and highly selective small molecule inhibitor of FXIa.

中文翻译：

---

肠胃外小分子凝血因子XIa抑制剂临床候选药物的发现（BMS-962212）

XIa因子（FXIa）是一种凝血酶，参与凝血酶生成的扩增。越来越多的证据表明，直接抑制FXIa可以阻止病理性血栓形成，同时保持正常止血。临床前研究使用多种降低FXIa活性的方法，包括FXIa的直接抑制剂，已证明在不增加出血的情况下具有良好的抗血栓形成作用。在此潜力的基础上，我们着力于确定FXIa的有效抑制剂，重点是发现一种可在医院环境中使用的急性抗血栓形成剂。本文中，我们描述了一种有效的FXIa临床候选物55（FXIa K _i= 0.7 nM），在血栓形成模型中具有出色的临床前功效，并且水溶性适合静脉内给药。BMS-962212是FXIa的可逆，直接和高选择性小分子抑制剂。