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A Study of Milvexian Versus Apixaban in Participants With Atrial Fibrillation

Phase 3
Active, not recruiting
Conditions
Atrial Fibrillation
Interventions
Registration Number
NCT05757869
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to evaluate if milvexian is at least as effective as apixaban for reducing the risk of the composite stroke and non-central nervous system (CNS) systemic embolism.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
20296
Inclusion Criteria
  • Minimum age of 18 years
  • Medically stable and appropriate for chronic antithrombotic treatment
  • Atrial fibrillation eligible to receive anticoagulation
  • Participant must satisfy one or both of the following categories of risk factors (a or b): a) one or more of the following risk factors: i) age greater than or equal to 75 years, ii) history of any type of stroke including symptomatic stroke of any kind. b) two or more of the following risk factors: i) age between 65 and 74 years, ii) hypertension, iii) diabetes mellitus, iv) atherosclerotic vascular disease, v) heart failure
Exclusion Criteria
  • Hemodynamically significant valve disease or those with valve disease that will potentially require surgical valve replacement during the study
  • Any condition other than AF that requires chronic anticoagulation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MilvexianPlaceboParticipants will receive milvexian 100 milligrams (mg) orally, twice daily and placebo that matches apixaban beginning on Day 1 through end of treatment (EOT). Participants after the EOT visit may have an option to receive open-label apixaban at the appropriate dose (5 mg or 2.5 mg, twice daily), for which the sponsor provides a 30-day supply.
ApixabanApixaban PlaceboParticipants will receive a placebo that matches milvexian and a capsule containing apixaban 5 mg or 2.5 mg orally, twice daily. Participants after the EOT visit may have an option to receive open-label apixaban (5 mg or 2.5 mg, twice daily) at the appropriate dose, for which the sponsor provides a 30-day supply.
ApixabanApixabanParticipants will receive a placebo that matches milvexian and a capsule containing apixaban 5 mg or 2.5 mg orally, twice daily. Participants after the EOT visit may have an option to receive open-label apixaban (5 mg or 2.5 mg, twice daily) at the appropriate dose, for which the sponsor provides a 30-day supply.
MilvexianMilvexianParticipants will receive milvexian 100 milligrams (mg) orally, twice daily and placebo that matches apixaban beginning on Day 1 through end of treatment (EOT). Participants after the EOT visit may have an option to receive open-label apixaban at the appropriate dose (5 mg or 2.5 mg, twice daily), for which the sponsor provides a 30-day supply.
Primary Outcome Measures
NameTimeMethod
Time to the First Occurrence of Composite Endpoint of Stroke and Non-central nervous system (CNS) Systemic EmbolismUp to 4 years

Time to the first occurrence of composite endpoint of stroke and non-CNS systemic embolism will be reported.

Secondary Outcome Measures
NameTimeMethod
Time to the First Occurrence of International Society of Thrombosis and Hemostasis (ISTH) Major BleedingUp to 4 years

Time to the first occurrence of ISTH major bleeding will be reported.

Time to the First Occurrence of the Composite of ISTH Major and Clinically Relevant Non-major (CRNM) BleedingUp to 4 years

Time to the first occurrence of the composite of ISTH major and CRNM bleeding will be reported.

Time to the First Occurrence of Composite Endpoint of Stroke, Non-CNS Systemic Embolism and ISTH Major BleedingUp to 4 years

Time to the first occurrence of composite endpoint of stroke, non-CNS systemic embolism and ISTH major bleeding will be reported.

Time to the First Occurrence of Composite Endpoint of Cardiovascular (CV) Death, Myocardial Infarction (MI), Stroke, and Non-CNS Systemic EmbolismUp to 4 years

Time to the first occurrence of composite endpoint of CV death, MI, stroke, and non-CNS systemic embolism will be reported.

Time to CV DeathUp to 4 years

Time to CV death will be reported.

Time to the First Occurrence of Composite Endpoint of All-cause Death, MI, Stroke and Non-CNS Systemic EmbolismUp to 4 years

Time to the first occurrence of composite endpoint of all-cause death, MI, stroke and Non-CNS systemic embolism will be reported.

Time to the First Occurrence of Composite Endpoint of CV Death, MI, Stroke, Acute Limb Ischemia (ALI), and Urgent Hospitalization for Vascular cause of Ischemic NatureUp to 4 years

Time to the first occurrence of composite endpoint of CV death, MI, stroke, ALI \[any unanticipated revascularization or amputation of ischemic limb\]), and urgent hospitalization for vascular cause of ischemic nature (including deep vein thrombosis \[DVT\] and pulmonary embolism \[PE\]) will be reported.

Trial Locations

Locations (1030)

Advanced Cardiovascular, LLC

🇺🇸

Alexander City, Alabama, United States

Ascension St. Vincent's Health System

🇺🇸

Birmingham, Alabama, United States

SEC Clinical Research

🇺🇸

Dothan, Alabama, United States

HH Heart Center and Heart Center

🇺🇸

Huntsville, Alabama, United States

CB Flock Research Corporation

🇺🇸

Mobile, Alabama, United States

Mercy Gilbert Medical Center

🇺🇸

Gilbert, Arizona, United States

Valleywise Health Medical Center

🇺🇸

Phoenix, Arizona, United States

Arizona Arrhythmia Research Center

🇺🇸

Phoenix, Arizona, United States

Arizona Heart Hospital

🇺🇸

Phoenix, Arizona, United States

HonorHealth Neurology

🇺🇸

Scottsdale, Arizona, United States

Scroll for more (1020 remaining)
Advanced Cardiovascular, LLC
🇺🇸Alexander City, Alabama, United States

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