OCEANIC-STROKE: Rethinking Secondary Stroke Prevention with Dr. Mike Sharma

Send us Fan MailFor decades, antiplatelet therapy has been central to secondary prevention following noncardioembolic ischemic stroke. Could factor XIa inhibition offer another approach?Dr. Mike Sharma, principal investigator and first author of OCEANIC-STROKE, joins Dr. Maha Othman and Dr. Jameel Abdulrehman to discuss the phase 3 trial of asundexian for secondary stroke prevention.OCEANIC-STROKE randomized 12,327 patients with noncardioembolic ischemic stroke or high-risk TIA to asundexian or placebo in addition to antiplatelet therapy. Ischemic stroke occurred in 6.2% of patients receiving asundexian versus 8.4% receiving placebo, while rates of ISTH major bleeding were similar.The discussion explores why factor XIa is an attractive therapeutic target, the clinical implications and limitations of the results, patient selection, and why factor XIa inhibition may challenge conventional thinking about antithrombotic therapy.This episode was made possible through financial support from Bayer Inc. Thrombosis Canada maintained full editorial independence, and Bayer had no involvement in the selection of the guest, development of the questions, conduct of the interview, or review or approval of the final content.Sharma M, Dong Q, Hirano T, Kasner SE, Saver JL, Masjuan J, Demchuk AM, Cordonnier C, Bereczki D, Tsivgoulis G, Veltkamp R. Asundexian for secondary stroke prevention. New England Journal of Medicine. 2026 Apr 16;394(15):1467-79.Support the showhttps://thrombosiscanada.caRegister today for our upcoming conference on November 7, 2026 in Montreal at https://thrombosiscanada.ca/2026ConferenceTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada