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FDA Approves Sunharbo for Recurring Stroke Risk
14 Nov
Summary
- Sunharbo is approved to lower the risk of recurrent strokes.
- It blocks factor XIa, a key protein in blood clot formation.
- A trial showed a 26% relative reduction in ischemic stroke risk.

The FDA has granted approval for Sunharbo (asundexian), a new medication designed to decrease the risk of recurrent strokes in certain adult patients. Administered as a daily 50-mg pill, Sunharbo is intended for adults who have recently experienced a stroke caused by a blood clot or a transient ischemic attack (TIA).
This innovative drug targets and blocks factor XIa, a specific protein instrumental in the blood clotting process. Clinical trial data from 37 countries revealed that daily Sunharbo, combined with antiplatelet therapy, resulted in a 26% relative reduction in ischemic stroke risk compared to a placebo. While generally not increasing major bleeding significantly, gastrointestinal bleeding was more common, and major bleeding saw an increase in patients over 75 during the initial 90 days.
Patients receiving Sunharbo also experienced a lower incidence of stroke, heart attack, or death from any cause. The trial, published in The New England Journal of Medicine, noted limitations including an average treatment period of 14 months, leaving long-term safety and effectiveness unclear. It also excluded individuals with specific heart conditions or more severe strokes.
Experts emphasize that Sunharbo is not for strokes caused by atrial fibrillation or heart valve issues. They also stress that medication is only one component of stroke prevention, highlighting the importance of lifestyle changes like smoking cessation, cholesterol management, healthy eating, and regular exercise. Patients are advised to discuss Sunharbo with their healthcare team soon after a stroke, ideally within 72 hours of hospital admission, to determine its suitability.