Abelacimab Versus Rivaroxaban in Patients With Atrial Fibrillation on Antiplatelet Therapy: A Prespecified Analysis of the AZALEA-TIMI 71 Trial
Authors' conclusion
Inhibition of factor XI with abelacimab consistently reduced bleeding compared with rivaroxaban regardless of concomitant APT use, with greater absolute reductions in bleeding in those requiring concomitant APT.
Study context
- Population
- Patients with AF, stratified by planned use of concomitant antiplatelet therapy (APT)318 (24.7%) on APT
- Participants
- 1,287 patients
- Comparison
- Abelacimab 90 mg or 150 mg monthly SC vs rivaroxaban, by concomitant APT
- Primary endpoint
- Major or clinically relevant nonmajor bleeding
Methodological detailsstratified by planned concomitant APT
- Stratified by planned concomitant APT
Primary result
As reported in the abstract
Major or clinically relevant nonmajor bleeding, by concomitant APT (subgroups)
Rivaroxaban
- With APT
- 10.6 per 100 patient-years
- Without APT
- 7.7 per 100 patient-years
Abelacimab 90 mg
- With APT
- 2.5 per 100 patient-years
- Without APT
- 2.7 per 100 patient-years
Abelacimab 150 mg
- With APT
- 3.5 per 100 patient-years
- Without APT
- 3.1 per 100 patient-years
With APT
Rivaroxaban10.6 per 100 patient-years
Abelacimab 90 mg2.5 per 100 patient-years
Abelacimab 150 mg3.5 per 100 patient-years
Without APT
Rivaroxaban7.7 per 100 patient-years
Abelacimab 90 mg2.7 per 100 patient-years
Abelacimab 150 mg3.1 per 100 patient-years
Each group vs rivaroxabanAdjusted hazard ratio (95% CI)
Abelacimab 90 mgwith APT; absolute risk reduction 8.1
0.26(0.10–0.70)
Abelacimab 150 mgwith APT; absolute risk reduction 7.1
0.30(0.12–0.74)
Abelacimab 90 mgwithout APT; absolute risk reduction 5.0
0.34(0.19–0.60)
Abelacimab 150 mgwithout APT; absolute risk reduction 4.6
0.40(0.23–0.68)
Original publication
Abelacimab Versus Rivaroxaban in Patients With Atrial Fibrillation on Antiplatelet Therapy: A Prespecified Analysis of the AZALEA-TIMI 71 Trial. Circulation. Published 23 June 2025. doi:10.
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