The interview aims to explore the implications of the positive topline Phase III OCEANIC-STROKE findings for asundexian, a once-daily oral Factor XIa inhibitor evaluated in secondary stroke prevention. Discussion will focus on the efficacy–safety balance, the significance of reducing ischemic stroke risk without increasing ISTH major bleeding, the potential positioning of Factor XIa inhibition relative to current antithrombotic standards, and considerations for regulatory pathways following Fast Track designation.