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Safety in Adult Participants With Atrial Fibrillation Who Are Treated With Anticoagulation

RecruitingPhase 2

A Phase 2, Randomized, Multicenter, Open-label, Blinded-endpoint Study to Evaluate the Safety of REGN7508 and REGN9933, Monoclonal Antibodies Against FXI, Versus Apixaban in Participants With Atrial Fibrillation (ROXI-ATLAS)

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
Key Inclusion Criteria:

1. Has AF or flutter (paroxysmal or persistent), not felt to be secondary to a reversible cause, and an indication for indefinite anticoagulation treatment as described in the protocol
2. Meets one of the following:

   1. CHA2DS2-VA \[C: Congestive heart failure; H: Hypertension; A2: Age ≥75 years (double points); D: Diabetes mellitus; S2: Stroke or TIA or Thromboembolism (double points); V: Vascular disease; A: Age 65-74 years\] score ≥2 and Oral Anticoagulant (OAC) naïve or
   2. CHA2DS2-VA score ≥3 or
   3. CHA2DS2-VA score of 2 and at least 1 enrichment criteria as described in the protocol
3. Must have an International Normalization Ratio (INR) \<2.5 at the time of randomization if taking warfarin or another Vitamin K Antagonist (VKA)

Key Exclusion Criteria:

1. Has a mechanical heart valve prosthesis (Note: transcatheter aortic valve replacement is not an exclusion)
2. Has known moderate-to-severe mitral stenosis
3. Has had successful ablation therapy or Left Atrial Appendage (LAA) occlusion/exclusion, or planned ablation or LAA occlusion/exclusion as described in the protocol
4. Had an ischemic stroke within 2 days prior to randomization
5. Has estimated Glomerular Filtration Rate (eGFR) \<15 mL/min/1.73m\^2 within 30 days prior to randomization or on dialysis or expected to be started as described in the protocol
6. Has a history of central nervous system bleeding within 30 days prior to randomization

Note: Other protocol-defined Inclusion/ Exclusion criteria apply

About the study

This study is researching experimental drugs called REGN7508 and REGN9933. The study is focused on participants who have atrial fibrillation, which means that the heart beats too fast and unevenly. REGN7508 and REGN9933 are designed to help stop blood clots forming in patients with atrial fibrillation.

The aim of the study is to see how well REGN7508 and REGN9933 work in patients that get medicine for their atrial fibrillation. The bleeding effects of REGN7508 and REGN9933 will be compared to another medicine (apixaban), which is available on the market to treat and prevent formation of blood clots.

The study is looking at several other research questions, including:

* What side effects may happen from taking REGN7508 or REGN9933 * How well do the study drugs reduce the risk of having a stroke * How much of REGN7508 or REGN9933 is in the blood at different times * Whether the body makes antibodies against REGN7508 or REGN9933 (which could make the drugs less effective or could lead to side effects)

What is being tested

Sponsor: Regeneron Pharmaceuticals · Participants: 1,200 · Started: Oct 20, 2025

Contact the study team

Official record on ClinicalTrials.gov — NCT07175428

Locations in the U.S.

AlabamaSEC Clinical Research, Dothan
Eastern Shore Research Institute, Fairhope
CaliforniaValley Clinical Trials, Inc, Covina
North Coast Cardiology, Encinitas
Mission Cardiovascular Research Institute, Fremont
National Institute of California Heart and Vein Specialists, Huntington Beach
Profound Research LLC at Southern California Heart Specialists, Pasadena
Empire Clinical Research, Pomona
The Cardiovascular Center, Redding
Northbay Clinical Research Center, Santa Rosa
Cardiology Associates Medical Group, Ventura
Interventional Cardiology Medical Group, West Hills
FloridaNouvelle Clinical Research LLC, Cutler Bay
South Florida Research Organization LLC, Medley
Inpatient Research Clinic LLC, Miami Lakes
Cardiovascular Center of Sarasota Foundation for Research and Education, Sarasota
Clinical Site Partners, LLC DBA Flourish Research, Winter Park
GeorgiaGrady Health System, Atlanta
NSC Research, Inc, Johns Creek
IndianaBlue Coast Research Center, LLC, Indianapolis
Franciscan Physician Network, Indiana Heart Physicians, Indianapolis
Indiana University, Indianapolis
Indiana Medical Research, Merrillville
Reid Physician Associates, Richmond
LouisianaMonroe Research, LLC, West Monroe
MarylandAnderson Medical Research, Ft. Washington
MassachusettsBeth Israel Lahey Health, Beth Israel Deaconess Medical Center (BIDMC), Boston
MichiganProfound Research, Millennium Cardiology, Farmington Hills
AA Medical Research Center (MRC), Flint
MinnesotaFairview Health Services, Maplewood
North CarolinaMoses Cone Hospital Operating Corporation dba Cone Health, Lebauer-Brodie Center for Cardiovascular Research, Greensboro
OhioK&R Research LLC, Marion
Advanced Medical Research, Maumee
South DakotaMonument Health Clinical Research, Rapid City
TennesseeEast Coast Institute for Research, Jefferson City, Jefferson City
TexasPharmaTex Research, Amarillo
Complete Heart Care P.A., McKinney
Texas Institute of Cardiology PA, McKinney
Synergy Group Medical, LLC, Missouri City
Permian Research Foundation, Odessa
Tyler Cardiovascular Consultants, Tyler
UtahAlpine Research TC, Clinton

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.