Milvexian

Milvexian
Clinical data
Other names	BMS-986177, JNJ-70033093
Routes of; administration	By mouth
ATC code	None;
Legal status
Legal status	Investigational;
Pharmacokinetic data
Elimination half-life	11.4–18.1 h
Identifiers
	IUPAC name (9R,13S)-13-{4-[5-Chloro-2-(4-chloro-1H-1,2,3-triazol-1-yl)phenyl]-6-oxo-1(6H)-pyrimidinyl}-3-(difluoromethyl)-9-methyl-3,4,7,15-tetraazatricyclo[12.3.1.02,6]octadeca-1(18),2(6),4,14,16-pentaen-8-one;
CAS Number	1802425-99-5;
PubChem CID	118277544;
DrugBank	DB16233;
ChemSpider	76803905;
UNII	0W79NDQ608;
KEGG	D11802;
ChEMBL	ChEMBL4112929;
Chemical and physical data
Formula	C28H23Cl2F2N9O2
Molar mass	626.45 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES C[C@@H]1CCC[C@H](n2cnc(-c3cc(Cl)ccc3-n3cc(Cl)nn3)cc2=O)c2cc(ccn2)-c2c(cnn2C(F)F)NC1=O;
	InChI InChI=1S/C28H23Cl2F2N9O2/c1-15-3-2-4-23(20-9-16(7-8-33-20)26-21(36-27(15)43)12-35-41(26)28(31)32)39-14-34-19(11-25(39)42)18-10-17(29)5-6-22(18)40-13-24(30)37-38-40/h5-15,23,28H,2-4H2,1H3,(H,36,43)/t15-,23+/m1/s1; Key:FSWFYCYPTDLKON-CMJOXMDJSA-N;

Milvexian is a factor XIa inhibitor which acts as an anticoagulant. It is taken by mouth. As of late 2021, it was under study for the prevention of blood clots in patients undergoing surgery.^[2] In 2018–2023, Bristol-Myers Squibb studied milvexian for the prevention of stroke.^[3]

References

^ Perera V, Wang Z, Luettgen J, Li D, DeSouza M, Cerra M, Seiffert D (September 2021). "First-in-human study of milvexian, an oral, direct, small molecule factor XIa inhibitor". Clinical and Translational Science. 15 (2): 330–342. doi:10.1111/cts.13148. PMC 8841437. PMID 34558200. S2CID 237617815.
^ Weitz JI, Strony J, Ageno W, Gailani D, Hylek EM, Lassen MR, et al. (November 2021). "Milvexian for the Prevention of Venous Thromboembolism". The New England Journal of Medicine. 385 (23): 2161–2172. doi:10.1056/NEJMoa2113194. PMC 9540352. PMID 34780683. S2CID 244132392.
^ "A Study on BMS-986177 for the Prevention of a Stroke in Patients Receiving Aspirin and Clopidogrel (AXIOMATIC-SSP)". ClinicalTrial.gov. U.S. National Library of Medicine. Retrieved 26 June 2023.

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[1] Perera V, Wang Z, Luettgen J, Li D, DeSouza M, Cerra M, Seiffert D (September 2021). "First-in-human study of milvexian, an oral, direct, small molecule factor XIa inhibitor". Clinical and Translational Science. 15 (2): 330–342. doi:10.1111/cts.13148. PMC 8841437. PMID 34558200. S2CID 237617815.

[2] Weitz JI, Strony J, Ageno W, Gailani D, Hylek EM, Lassen MR, et al. (November 2021). "Milvexian for the Prevention of Venous Thromboembolism". The New England Journal of Medicine. 385 (23): 2161–2172. doi:10.1056/NEJMoa2113194. PMC 9540352. PMID 34780683. S2CID 244132392.

[3] "A Study on BMS-986177 for the Prevention of a Stroke in Patients Receiving Aspirin and Clopidogrel (AXIOMATIC-SSP)". ClinicalTrial.gov. U.S. National Library of Medicine. Retrieved 26 June 2023.

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