Similar to the risk associated with direct FIIa inhibitors and direct FXa inhibitors, if uncommunicated or unrecognised, the presence of asundexian or milvexian in patient-derived plasma samples may lead to an apparent moderate-to-severe intrinsic factor deficiency, consistent with the presence of a non-specific ‘inhibitor’ by multi-dilutional one-stage clotting assays. This evidence concerns the gene F10 and hyperinsulinemic hypoglycemia, familial, 4.