OCEANIC-STROKE Incident Infarcts
(2026)Objective
Secondary analysis of OCEANIC-STROKE describing the severity, treatment, and outcomes of incident ischemic strokes occurring on asundexian vs placebo for secondary prevention after non-cardioembolic stroke/TIA.
Study Summary
• Incident ischemic stroke: 6.6% (asundexian) vs 8.8% (placebo), NNT=46.
• Asundexian arm: less disabling/fatal stroke, lower NIHSS at event.
• Lower need for EVT among incident strokes on asundexian.
• Similar rates of hemorrhagic transformation across arms.
• Asundexian arm: less disabling/fatal stroke, lower NIHSS at event.
• Lower need for EVT among incident strokes on asundexian.
• Similar rates of hemorrhagic transformation across arms.
Intervention
Asundexian 50 mg vs placebo (factor XIa inhibitor for secondary prevention)
Inclusion Criteria
International, n=12,327. Within 72 h of onset; ischemic stroke (NIHSS <=15) or high-risk TIA (ABCD2 6-7); non-cardioembolic origin.
Study Design
Arms: Asundexian 50 mg vs placebo
Patients per Arm: Asundexian arm: 404 incident strokes; Placebo arm: 545 incident strokes (parent trial N=12,327)
Outcome
• Incident ischemic stroke rate: 6.6% vs 8.8%, NNT=46.
• Less disabling/fatal stroke with asundexian.
• Lower stroke severity (NIHSS) with asundexian.
• Lower need for EVT with asundexian.
• Similar hemorrhagic transformation rates.
• Less disabling/fatal stroke with asundexian.
• Lower stroke severity (NIHSS) with asundexian.
• Lower need for EVT with asundexian.
• Similar hemorrhagic transformation rates.