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ZEUS - A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With Cardiovascular Disease, Chronic Kidney Disease and Inflammation

Phase 3
Active, not recruiting
Conditions
Cardiovascular Risk
Chronic Kidney Disease
Inflammation
Interventions
Drug: Ziltivekimab B
Drug: Placebo (Ziltivekimab B)
Drug: Ziltivekimab C
Drug: Placebo (Ziltivekimab C)
Registration Number
NCT05021835
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This study is conducted to see if ziltivekimab reduces the risk of having cardiovascular events (for example heart attack and stroke) in people with cardiovascular disease, chronic kidney disease and inflammation.

Participants will either get ziltivekimab (active medicine) or placebo (a dummy medicine which has no effect on the body). This is known as the study medicine. Which treatment participants get is decided by chance. Participants chance of getting ziltivekimab or placebo is the same.

Ziltivekimab is not yet approved in any country or region in the world. It is a new medicine doctors cannot prescribe.

Participants will get the study medicine in a pre filled syringe. Participants will need to use the pre filled syringe to inject the study medicine into a skinfold once-monthly.

The study is expected to last for up to 4 years. Participants will have up to 20 clinic visits. Participants will have blood and urine samples taken at most of the clinic visits.

Participants will have their heart examined using sound waves (echocardiography) and electrodes (electrocardiogram).

Women cannot take part if pregnant, breast-feeding or planning to get pregnant during the study period.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
6200
Inclusion Criteria
  • Chronic kidney disease defined by one of the below:

    1. Estimated glomerular filtration rate (eGFR) greater than or equal to (>=) 15 and below 60 mL/min/1.73 m^2 (using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation)
    2. Urinary albumin-to-creatinine ratio (UACR) >= 200 milligrams per gram (mg/g) and eGFR >= 60 mL/min/1.73 m2 (using the CKD-EPI creatinine equation)
  • Serum high-sensitivity C-reactive protein (hs-CRP) greater than or equal to 2 milligram per liter (mg/L)

  • Evidence of atherosclerotic cardiovascular disease (ASCVD) by one or more of the following:

    a) Coronary heart disease defined as at least one of the following: i. Documented history of MI ii. Prior coronary revascularisation procedure iii. greater than or equal to 50% stenosis in major epicardial coronary artery documented by cardiac catheterisation or CT coronary angiography b) Cerebrovascular disease defined as at least one of the following: i. Prior stroke of atherosclerotic origin ii. Prior carotid artery revascularisation procedure iii. greater than or equal to 50% stenosis in carotid artery documented by X-ray angiography, MR angiography, CT angiography or Doppler ultrasound.

    c) Symptomatic peripheral artery disease (PAD) defined as at least one of the following: i. Intermittent claudication with an ankle-brachial index (ABI) below or equal to 0.90 at rest ii. Intermittent claudication with a greater than or equal to 50% stenosis in peripheral artery (excluding carotid) documented by X-ray angiography, MR angiography, CT angiography or Doppler ultrasound iii. Prior peripheral artery (excluding carotid) revascularisation procedure iv. Lower extremity amputation at or above ankle due to atherosclerotic disease (excluding e.g. trauma or osteomyelitis).

Exclusion Criteria
  • Clinical evidence of, or suspicion of, active infection at the discretion of the investigator.
  • Myocardial infarction, stroke, hospitalisation for unstable angina pectoris, or transient ischaemic attack within 60 days prior to randomisation (visit 2).
  • Planned coronary, carotid or peripheral artery revascularisation known on the day of randomisation (visit 2).
  • Major cardiac surgical, non-cardiac surgical, or major endoscopic procedure (thoracoscopic or laparoscopic) within the past 60 days prior to randomisation (visit 2) or any major surgical procedure planned at the time of randomisation (visit 2).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ZiltivekimabZiltivekimab BParticipants will receive Ziltivekimab B or Ziltivekimab C subcutaneously once monthly for up to 4 years.
ZiltivekimabZiltivekimab CParticipants will receive Ziltivekimab B or Ziltivekimab C subcutaneously once monthly for up to 4 years.
PlaceboPlacebo (Ziltivekimab B)Participants will receive either placebo (Ziltivekimab B) or placebo (Ziltivekimab C) subcutaneously once monthly for up to 4 years.
PlaceboPlacebo (Ziltivekimab C)Participants will receive either placebo (Ziltivekimab B) or placebo (Ziltivekimab C) subcutaneously once monthly for up to 4 years.
Primary Outcome Measures
NameTimeMethod
Time to first occurrence of 3-point Major Adverse Cardiovascular Event (MACE), a composite endpoint consisting of: Cardiovascular (CV) death, non-fatal Myocardial Infarction (MI) and non-fatal strokeFrom randomisation (month 0) to end-of-study (up to 48 months)

Months

Secondary Outcome Measures
NameTimeMethod
Time to first occurrence of expanded MACE, a composite endpoint consisting of: CV death, non-fatal MI, non-fatal stroke and hospitalisation for unstable angina pectoris requiring urgent coronary revascularisationFrom randomisation (month 0) to end-of-study (up to 48 months)

Months

Number of heart failure hospitalisations or urgent heart failure visits or CV deathsFrom randomisation (month 0) to end-of-study (up to 48 months)

Count

Time to first occurrence of MI (fatal and non-fatal).From randomisation (month 0) to end-of-study (up to 48 months).

Months

Change in eGFR (CKD-EPI))From randomisation (month 0) to 2 years (24 months)

mL/min/1.73 m\^2

Annual rate of change in eGFR (CKD-EPI) (total eGFR slope)From randomisation (month 0) to end-of-study (up to 48 months).

mL/min/1.73 m\^2/ year

Number of hospitalisations with infection as primary cause or death due to infection.From randomisation (month 0) to end-of-study (up to 48 months).

Count

Change in Short Form 36 (SF-36) Physical Component Score (PCS)From randomisation (month 0) to 2 years (24 months)

Score on scale

Time to first occurrence of a composite kidney endpoint consisting of: CV death, onset of persistent atleast 40 percent (%) reduction in eGFR (CKD-epidemiology collaboration [CKD-EPI]) compared with baseline, kidney failureFrom randomisation (month 0) to end-of-study (up to 48 months)

Months

Time to occurrence of all-cause mortalityFrom randomisation (month 0) to end-of-study (up to 48 months)

Months

Time to first occurrence of each of the individual components of the expanded MACE endpoint and the kidney composite endpoint.From randomisation (month 0) to end-of-study (up to 48 months).

Months

Time to first occurrence of stroke (fatal and non-fatal).From randomisation (month 0) to end-of-study (up to 48 months).

Months

Time to first occurrence of a composite MACE endpoint consisting of: all-cause mortality, non-fatal MI and non-fatal strokeFrom randomisation (month 0) to end-of-study (up to 48 months).

Months

Time to first occurrence of a 4-component kidney endpoint consisting of: onset of persistent at least 40% reduction in eGFR (CKD-EPI) compared with baseline, kidney failureFrom randomisation (month 0) to end-of-study (up to 48 months).

Months

Time to first occurrence of coronary revascularisationFrom randomisation (month 0) to end-of-study (up to 48 months).

Months

Change in Urinary Abumin-to-Ceatinine ratio (UACR).From randomisation (month 0) to 2 years (24 months).

Percentage

Change in high-sensitivity C-reactive protein (hs-CRP)From randomisation (month 0) to 2 years (24 months

Percentage

Change in N-terminal-pro-brain natriuretic peptide ( NT-pro-BNP)From randomisation (month 0) to 2 years (24 months)

Percentage

Change in left ventricular ejection fraction (LVEF)From randomisation (month 0) to 2 years (24 months)

Percentage

Number of events of atrial fibrillationFrom randomisation (month 0) to end-of-study (up to 48 months).

Count

Change in haemoglobinFrom randomisation (month 0) to 2 years (24 months)

Grams per deciliter (g/dL)

Trial Locations

Locations (821)

Uni of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Chambliss Clinical Trials, LLC

🇺🇸

Montgomery, Alabama, United States

Aventiv Research Inc.

🇺🇸

Mesa, Arizona, United States

Unity Health-Searcy Medical Center

🇺🇸

Searcy, Arkansas, United States

National Heart Institute Cal

🇺🇸

Beverly Hills, California, United States

Valley Clinical Trials

🇺🇸

Covina, California, United States

Valiance Clinical Research

🇺🇸

Huntington Park, California, United States

Balboa Nephro Med Gr Inc LaMes

🇺🇸

La Mesa, California, United States

First Valley Medical Group

🇺🇸

Lancaster, California, United States

VA Loma Linda Hlthcr Sys

🇺🇸

Loma Linda, California, United States

Scroll for more (811 remaining)
Uni of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States

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