Thrombophilia

disease
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Also known as excessive blood clottinghypercoagulabilityhypercoagulability statehypercoagulable

Summary

Thrombophilia (MONDO:0002305) is a disease caused by variants in FGA, FGB, and FGG, with 3 cohort genes (33 GWAS associations across 10 studies) and 36 clinical trials. The dominant Reactome pathway is Aggregated β-amyloid interacts with fibrinogen (3 cohort genes). Top therapeutic interventions include dalteparin sodium, alteplase, and estradiol.

At a glance

  • Causal genes: FGA (GenCC Strong), FGB (GenCC Strong), FGG (GenCC Strong)
  • Cohort genes: 3
  • GWAS associations: 33
  • ClinVar variants: 1
  • Clinical trials: 36

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namethrombophilia
Mondo IDMONDO:0002305
EFOEFO:0009315
MeSHD019851
Orphanet64738
DOIDDOID:2452
ICD-111733531851
NCITC84479
SNOMED CT234467004
UMLSC0398623
MedGen98306
GARD0023114
Is cancer (heuristic)no

Also known as: excessive blood clotting · hypercoagulability · hypercoagulability state · hypercoagulable

Data availability: 1 ClinVar variant · 33 GWAS associations (10 studies) · 6 GenCC gene-disease records.

Disease family

An umbrella term covering 4 Mondo subtypes.

Classification path: disease › human disease › disease by body system or component › hematologic disorderblood coagulation diseasethrombophilia

Related subtypes (7): marantic endocarditis, hemolytic-uremic syndrome, coagulation protein disease, hemorrhagic disease of newborn, thrombotic microangiopathy, inherited blood coagulation disorder, prekallikrein deficiency

Subtypes (4): disseminated intravascular coagulation, protein S deficiency, thrombotic thrombocytopenic purpura, inherited thrombophilia

Genetics & variants

GWAS landscape

33 GWAS associations across 10 studies. Top hits map to 9 distinct genes (as reported by GWAS).

Top associations by p-value

rsIDp-valueGeneRisk alleleOdds ratio
rs1451634541e-323ATP1B1T2.21
rs779776111e-323ATP1B1T1.77
rs17999633e-96F2G1.33
rs1154787356e-48ABOA0.44
rs1447374473e-24NME7, ATP1B1C2.24
rs76540934e-16FGG - LRATA0.23
rs18946921e-14SLC19A2 - F5G2.16
rs42534171e-14F11T0.21
rs131303183e-14FGG - LRATT0.23
chr4:1871875695e-13G0.21
rs1922746527e-13OR5BP1P - LRRC55A1.06
rs5355558973e-12ZNF160T3.09
rs5723808107e-12LINC01876C4.25
rs10037625871e-11ELK1P1 - ADCY1C3.31
rs1416873792e-11FADS2BA0.96
rs1811451152e-11LINC02296 - LINC02330A2.23
rs5578190203e-11ATXN10 - WNT7BC2.37
rs1457135714e-11LINC02141 - NPAP1LA2.29
rs1148561512e-08WWOX?

Top studies (by case count)

StudyLead authorYearCasesControlsTitle
GCST90475802Verma A20242,636447,006Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90475804Verma A20242,443447,470Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90651565Liu TY2025939231,777Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population.
GCST90651591Liu TY2025916231,777Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population.
GCST90475801Verma A2024578120,902Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90479978Verma A2024578120,902Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90475803Verma A2024522121,041Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90479977Verma A2024522121,041Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90476488Verma A202420059,565Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90727280Kim HI202613443,892Exome sequencing and analysis of 44,028 British South Asians enriched for high autozygosity.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

TierVariants
Tier 1: coding0
Tier 2: splice/UTR1
Tier 3: regulatory0
Tier 4: intronic/intergenic18

MAF distribution

BucketVariants
common (>=0.05)5
low_freq (0.01-0.05)4
rare (<0.01)9
unknown1

Functional consequences

ConsequenceCount
intron_variant9
intergenic_variant6
non_coding_transcript_exon_variant2
3_prime_UTR_variant1
unknown1

Top variants

rsIDChrPosAllelesMAFConsequenceGenep-valueTier
rs1451634541169121510T>A,C0.023intron_variantATP1B11e-323Tier 4: intronic/intergenic
rs779776111169112554T>C,G0.036non_coding_transcript_exon_variantATP1B11e-323Tier 4: intronic/intergenic
rs17999631146739505G>A0.0123_prime_UTR_variantF23e-96Tier 2: splice/UTR
rs1154787359133274295A>T0.158intron_variantABO6e-48Tier 4: intronic/intergenic
rs1447374471169191220C>T0.004intron_variantNME7, ATP1B13e-24Tier 4: intronic/intergenic
rs76540934154623920A>T0.248intergenic_variantFGG - LRAT4e-16Tier 4: intronic/intergenic
rs18946921169498416G>A0.022non_coding_transcript_exon_variantSLC19A2 - F51e-14Tier 4: intronic/intergenic
rs42534174186277851T>C,G0.345intron_variantF111e-14Tier 4: intronic/intergenic
rs131303184154617318T>G0.222intergenic_variantFGG - LRAT3e-14Tier 4: intronic/intergenic
chr4:1871875690.3875e-13Tier 4: intronic/intergenic
rs1922746521157069003A>G,T0.004intergenic_variantOR5BP1P - LRRC557e-13Tier 4: intronic/intergenic
rs5355558971953088515T>C0intron_variantZNF1603e-12Tier 4: intronic/intergenic
rs5723808102156046828C>A,T0intron_variantLINC018767e-12Tier 4: intronic/intergenic
rs1003762587745434577C>G,T0intron_variantELK1P1 - ADCY11e-11Tier 4: intronic/intergenic
rs1416873791156899346A>G0.004intron_variantFADS2B2e-11Tier 4: intronic/intergenic
rs1811451151487584038A>G0intergenic_variantLINC02296 - LINC023302e-11Tier 4: intronic/intergenic
rs5578190202245898102C>T0.002intergenic_variantATXN10 - WNT7B3e-11Tier 4: intronic/intergenic
rs1457135711660117264A>C,G0.002intergenic_variantLINC02141 - NPAP1L4e-11Tier 4: intronic/intergenic
rs1148561511678893311G>Aintron_variantWWOX2e-08Tier 4: intronic/intergenic

ClinVar germline variants

1 retrieved; paginated sample, class counts are floors:

1 uncertain significance

ClinVarVariant (HGVS)GeneClassificationReview
26791846;XX;t(6;20)(q25.1;p13)dnUncertain significancecriteria provided, single submitter

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 29 · Orphanet: 13 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
FGAStrongAutosomal dominantthrombophilia14
FGBStrongAutosomal dominantthrombophilia7
FGGStrongAutosomal dominantthrombophilia8

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
FGAOrphanet:101041Familial hypofibrinogenemia
FGAOrphanet:248408Familial hypodysfibrinogenemia
FGAOrphanet:93562AFib amyloidosis
FGAOrphanet:98880Familial afibrinogenemia
FGAOrphanet:98881Familial dysfibrinogenemia
FGBOrphanet:101041Familial hypofibrinogenemia
FGBOrphanet:248408Familial hypodysfibrinogenemia
FGBOrphanet:98880Familial afibrinogenemia
FGBOrphanet:98881Familial dysfibrinogenemia
FGGOrphanet:101041Familial hypofibrinogenemia
FGGOrphanet:248408Familial hypodysfibrinogenemia
FGGOrphanet:98880Familial afibrinogenemia
FGGOrphanet:98881Familial dysfibrinogenemia

Cohort genes → proteins

3 cohort genes, 3 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence3

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
FGAHGNC:3661ENSG00000171560P02671Fibrinogen alpha chaingencc
FGBHGNC:3662ENSG00000171564P02675Fibrinogen beta chaingencc
FGGHGNC:3694ENSG00000171557P02679Fibrinogen gamma chaingencc

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
FGAFibrinogen alpha chainCleaved by the protease thrombin to yield monomers which, together with fibrinogen beta (FGB) and fibrinogen gamma (FGG), polymerize to form an insoluble fibrin matrix.
FGBFibrinogen beta chainCleaved by the protease thrombin to yield monomers which, together with fibrinogen alpha (FGA) and fibrinogen gamma (FGG), polymerize to form an insoluble fibrin matrix.
FGGFibrinogen gamma chainTogether with fibrinogen alpha (FGA) and fibrinogen beta (FGB), polymerizes to form an insoluble fibrin matrix.

Protein-family classification

Druggable: 0 · Difficult: 0 · Unknown: 3 · Druggable fraction: 0.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Other/Unknown31.8×0.174

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
FGAOther/UnknownnoFibrinogen_a/b/g_C_dom, Fibrinogen_a/b/g_coil_dom, Fibrinogen_a/b/g_C_1
FGBOther/UnknownnoFibrinogen_a/b/g_C_dom, Fibrinogen_a/b/g_coil_dom, Fibrinogen_a/b/g_C_1
FGGOther/UnknownnoFibrinogen_a/b/g_C_dom, Fibrinogen_a/b/g_coil_dom, Fibrinogen_a/b/g_C_1

Expression context

Cohort genes with no expression data: 0.

3 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)3
unknown0

Top tissues across cohort

TissueCohort genes
liver3
right lobe of liver3
type B pancreatic cell2
islet of Langerhans1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
FGA153tissue_specificmarkerright lobe of liver, liver, islet of Langerhans
FGB159broadmarkerright lobe of liver, liver, type B pancreatic cell
FGG157broadmarkerright lobe of liver, liver, type B pancreatic cell

Protein interactions among cohort

Intra-cohort edges: 3.

Hub genes (top 10 by interactor count)

SymbolInteractor count
FGB2,503
FGA2,327
FGG2,018

Intra-cohort edges

ABSources
FGAFGBintact, string_interaction
FGAFGGbiogrid_interaction, intact, string_interaction
FGBFGGbiogrid_interaction, string_interaction

Structural data

PDB: 3 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
FGGP0267947
FGBP0267541
FGAP0267139

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 22. Enrichment computed across 3 evidence-associated genes (3 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Aggregated β-amyloid interacts with fibrinogen32855.0×4e-10FGA, FGB, FGG
Fibrin formation3878.5×1e-08FGA, FGB, FGG
p130Cas linkage to MAPK signaling for integrins3761.3×1e-08FGA, FGB, FGG
GRB2:SOS provides linkage to MAPK signaling for Integrins3713.8×1e-08FGA, FGB, FGG
MyD88 deficiency (TLR2/4)3601.0×2e-08FGA, FGB, FGG
IRAK4 deficiency (TLR2/4)3571.0×2e-08FGA, FGB, FGG
Regulation of TLR by endogenous ligand3496.5×2e-08FGA, FGB, FGG
Integrin signaling3423.0×3e-08FGA, FGB, FGG
Signaling by high-kinase activity BRAF mutants3317.2×7e-08FGA, FGB, FGG
MAP2K and MAPK activation3285.5×9e-08FGA, FGB, FGG
Signaling by RAF1 mutants3278.5×9e-08FGA, FGB, FGG
Signaling by moderate kinase activity BRAF mutants3253.8×9e-08FGA, FGB, FGG
Paradoxical activation of RAF signaling by kinase inactive BRAF3253.8×9e-08FGA, FGB, FGG
Signaling downstream of RAS mutants3253.8×9e-08FGA, FGB, FGG
Signaling by BRAF and RAF1 fusions3170.4×3e-07FGA, FGB, FGG
MyD88:MAL(TIRAP) cascade initiated on plasma membrane3152.3×4e-07FGA, FGB, FGG
Integrin cell surface interactions3134.3×5e-07FGA, FGB, FGG
ER-Phagosome pathway3129.8×5e-07FGA, FGB, FGG
Platelet degranulation387.8×2e-06FGA, FGB, FGG
Post-translational protein phosphorylation266.8×3e-04FGA, FGG
Regulation of Insulin-like Growth Factor (IGF) transport and uptake by Insulin-like Growth Factor Binding Proteins (IGFBPs)257.7×4e-04FGA, FGG
Amyloid fiber formation134.3×0.029FGA

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
blood coagulation, fibrin clot formation31685.2×2e-09FGA, FGB, FGG
positive regulation of peptide hormone secretion31532.0×2e-09FGA, FGB, FGG
plasminogen activation31296.3×2e-09FGA, FGB, FGG
positive regulation of heterotypic cell-cell adhesion31296.3×2e-09FGA, FGB, FGG
protein polymerization3991.3×4e-09FGA, FGB, FGG
fibrinolysis3842.6×6e-09FGA, FGB, FGG
positive regulation of vasoconstriction3601.9×1e-08FGA, FGB, FGG
positive regulation of exocytosis3601.9×1e-08FGA, FGB, FGG
negative regulation of extrinsic apoptotic signaling pathway via death domain receptors3581.1×1e-08FGA, FGB, FGG
negative regulation of endothelial cell apoptotic process3495.6×2e-08FGA, FGB, FGG
positive regulation of substrate adhesion-dependent cell spreading3374.5×4e-08FGA, FGB, FGG
positive regulation of protein secretion3343.9×5e-08FGA, FGB, FGG
platelet aggregation3337.0×5e-08FGA, FGB, FGG
response to calcium ion3318.0×5e-08FGA, FGB, FGG
cell-matrix adhesion3163.6×4e-07FGA, FGB, FGG
induction of bacterial agglutination21872.4×5e-07FGA, FGB
protein-containing complex assembly3113.9×9e-07FGA, FGB, FGG
positive regulation of ERK1 and ERK2 cascade385.1×2e-06FGA, FGB, FGG
blood coagulation, common pathway12808.7×4e-04FGA
adaptive immune response256.2×5e-04FGA, FGB
cellular response to leptin stimulus1510.7×0.002FGB
innate immune response222.4×0.003FGA, FGB
cellular response to interleukin-1193.6×0.011FGB
protein secretion187.8×0.011FGG

Therapeutics

Drugs indicated for this disease

0 approved, 5 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

DrugDevelopment status
AspirinPhase 3 (in late-stage trials)
ClopidogrelPhase 3 (in late-stage trials)
Dalteparin SodiumPhase 3 (in late-stage trials)
Nadroparin CalciumPhase 3 (in late-stage trials)
Salicylic AcidPhase 3 (in late-stage trials)

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 1 · Undrugged: 2

Druggability breadth: 3 of 3 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
FGB12
FGA00
FGG00

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
SANGUINARIUM2FGB

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
FGB2Binding:2

Pharmacogenomics

Cohort genes with a PharmGKB record: 3; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

1 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

CompoundMax phaseCohort target (bioactivity)
SANGUINARIUM2FGB

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved1FGB
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug2FGA, FGG

Undrugged target profiles

2 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
FGA0FGB
FGG0FGB

Clinical trials & evidence

Clinical trials

Clinical trials: 36.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified30
PHASE33
PHASE42
PHASE21

Top trials by phase / activity

NCTPhaseStatusTitle
NCT01214772PHASE4COMPLETEDThe Effect of Heparin in Treatment IVF-ET Failure
NCT03531437PHASE4TERMINATEDComparison of Coagulation Profiles Between Zoely and Minidoz: RCT
NCT06153394PHASE3NOT_YET_RECRUITINGProlonged Hypercoagulability Following Major Liver Resection for Malignancy
NCT00967382PHASE3COMPLETEDTIPPS: Thrombophilia in Pregnancy Prophylaxis Study
NCT01046942PHASE3UNKNOWNThrombElastoGraphic Haemostatic Status and Antiplatelet Therapy After Coronary Artery Bypass Graft Surgery
NCT05540834PHASE2RECRUITINGViscoelastic Testing Guided Tissue Plasminogen Activator Treatment in Acute Respiratory Failure
NCT04398628Not specifiedRECRUITINGATHN Transcends: A Natural History Study of Non-Neoplastic Hematologic Disorders
NCT04537416Not specifiedACTIVE_NOT_RECRUITINGFertility, Hypercoagulability, and Inflammation (FREYA) Registry
NCT05853796Not specifiedRECRUITINGObservational Dutch Young Symptomatic StrokE studY - nEXT
NCT06727669Not specifiedRECRUITINGLongitudinal Cohort of Thrombosis and Hemostasis Diseases
NCT07108023Not specifiedNOT_YET_RECRUITINGHematological Disorders in EHPVO Patients
NCT07372170Not specifiedRECRUITINGObservational Study to Evaluate the Effectiveness of DOACS for Secondary Thrombosis Prevention in Low-risk Thrombotic APS Patients
NCT07571096Not specifiedRECRUITINGConstruction of a Multi-dimensional Risk Assessment System: a Clinical Study of Polycystic Ovary Syndrome Complicated With Thrombophilia
NCT00354796Not specifiedUNKNOWNThe Effect of Reduced Dose of Enoxaparin on the Outcomes of Treatment With Enoxaparin
NCT00356434Not specifiedTERMINATEDA Comparison of Sequential Compression Devices and Foot Pumps in the Obstetric Population
NCT00457184Not specifiedCOMPLETEDThrombophilia and Migraine, Are They Related?
NCT00883272Not specifiedCOMPLETEDEffect of DT56a (Femarelle) on the Coagulation System in the Treatment of Postmenopausal Women
NCT01160159Not specifiedTERMINATEDArterial Microcirculation, Macrocirculation and Thrombophilias
NCT01372553Not specifiedCOMPLETEDGuilford Genomic Medicine Initiative (GGMI)
NCT01416454Not specifiedCOMPLETEDThromboelastography to Assess Age-Related Coagulation Differences in Patients Undergoing Cesarean Delivery
NCT01486511Not specifiedUNKNOWNPulmonary Embolism After Liver Resection
NCT01487291Not specifiedCOMPLETEDPrevalence of Clinical and Laboratory Markers of Hypofibrinolysis in Psychotic Patients
NCT01905748Not specifiedUNKNOWNAcute Phase Reactions and Thrombophilia in Pediatric Patients With Migraine
NCT02139670Not specifiedCOMPLETEDThrombin Generation and Gestational Outcome
NCT02407730Not specifiedCOMPLETEDEFFects of Thrombophilia on the Outcomes of Assisted Reproduction Technologies
NCT02701452Not specifiedTERMINATEDOvarian Hyperstimulation Syndrome in Patients Triggered by GnRH Agonist for Excessive Follicular Response
NCT02718924Not specifiedCOMPLETEDDetecting Hypercoagulability in Morbidly Obese and Non Obese Parturients Following Cesarean Section Delivery
NCT03682419Not specifiedCOMPLETEDEvaluation of Precision and Accuracy of INR Measurements in a Point of Care Device (OPTIMAL)
NCT04059965Not specifiedWITHDRAWNAntiCoagulation Tracking InterVention and Evaluation
NCT04393805Not specifiedCOMPLETEDHeparins for Thromboprophylaxis in COVID-19 Patients: HETHICO Study in Veneto
NCT04503317Not specifiedCOMPLETEDEffect of Phototherapy With Exercise on Coagulation in Elderly
NCT04519398Not specifiedUNKNOWNInvestigating the Involvement of ACE and Angiotensinogen Genes’ Polymorphism Along With Other Thrombophilic Genotypes in Severe Forms of COVID-19 With/Without Thrombotic Events
NCT04736901Not specifiedCOMPLETEDEffect of Prophylactic and Therapeutic Anticoagulants in Egyptian Patients With COVID-19
NCT05225155Not specifiedCOMPLETEDEffect of Prophylatic Use of Enoxaparin in Women Undergoing in Vitro Fertilization Treatment
NCT05551078Not specifiedUNKNOWNThrombophilia Screening After Severe IUGR
NCT06171984Not specifiedUNKNOWNThrombophilia Assessment Under DOAC: Effectiveness of Activated Charcoal

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
DALTEPARIN SODIUM42
ALTEPLASE41
ESTRADIOL41
HEPARIN41
CHEMBL407189601
CHEMBL412840701
CHEMBL518243601