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Stroke and Systemic Embolism Prevention in Adult Participants With Atrial Fibrillation for Whom Oral Anticoagulation is Unsuitable

RecruitingPhase 3

A Master Protocol for a Phase 3, Randomized, Multicenter, Double-blind Study to Assess Stroke and Systemic Embolism Prevention With REGN7508 and REGN9933, Monoclonal Antibodies Against Factor XI, Versus Placebo in Participants With Atrial Fibrillation for Whom Oral Anticoagulation is Unsuitable (ROXI-INCLINE)

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
Key Inclusion Criteria:

1. Has AF or flutter (paroxysmal or persistent), not considered to be secondary to a reversible cause
2. At moderate to high risk for stroke defined as:

   1. CHA2DS2-VA \[C: Congestive heart failure; H: Hypertension; A2: Age ≥75 years (double points); D: Diabetes mellitus; S2: Stroke or TIA or Systemic embolism (double points); V: Vascular disease; A: Age 65-74 years\] score ≥4 OR
   2. CHA2DS2-VA score of 3 AND at least 1 enrichment criteria as described in the protocol
3. Shared decision making between the participant and provider determining that the bleeding risk of Oral Anticoagulant (OAC) therapy outweighs the benefits, making the participant unsuitable for OAC therapy as described in the protocol

Key Exclusion Criteria:

1. Has a mechanical heart valve prosthesis (Note: transcatheter aortic valve replacement is not an exclusion)
2. Had an ischemic stroke within 2 days prior to randomization
3. Has persistent, uncontrolled hypertension (per investigator's discretion)
4. Has a history of Central Nervous System (CNS) bleeding within 30 days prior to randomization
5. Has a life expectancy less than 12 months
6. Has participated in a prior Factor XI (FXI) inhibitor study

Note: Other protocol-defined Inclusion/ Exclusion criteria apply

About the study

This study is researching 2 different experimental drugs called REGN7508 and REGN9933 (called "study drugs"). The study is focused on people who have atrial fibrillation, which means that the heart beats too fast and unevenly. When this happens, blood cannot move smoothly through the heart; it can slow down or pool in one spot, which can lead to the formation of blood clots.

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 effective and safe REGN7508 and REGN9933, individually, are in preventing ischemic stroke or systemic embolism in people with atrial fibrillation who cannot or may choose to not take blood thinners.

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

* What side effects may happen from taking REGN7508 or REGN9933 * How well does REGN7508 or REGN9933 lower the risk of having an ischemic stroke and/or systemic embolism compared to the placebo * How well does REGN7508 or REGN9933 lower the risk of having a major health problem affecting heart and blood circulation compared to placebo * How well does REGN7508 or REGN9933 lower the risk of death compared to placebo * How much REGN7508 or REGN9933 is in the blood at different times * Whether the body makes antibodies against REGN7508 or REGN9933 (which could make the study drugs less effective or could lead to side effects)

What is being tested

Sponsor: Regeneron Pharmaceuticals · Participants: 2,628 · Started: Apr 3, 2026

Contact the study team

Official record on ClinicalTrials.gov — NCT07430956

Locations in the U.S.

AlabamaSEC Clinical Research, Dothan
ArkansasArkansas Cardiology P.A., Little Rock
CaliforniaMission Cardiovascular Research Institute, Fremont
National Institute of California Heart and Vein Specialists, Huntington Beach
Profound Research LLC at San Diego Cardiovascular Associates, La Jolla
Profound Research LLC at Southern California Heart Specialists, Pasadena
Cardiology Associates Medical Group, Ventura
Interventional Cardiology Medical Group, West Hills
FloridaSouth Florida Research Organization LLC, Medley
Sec Clinical Research, Pensacola
Cardiovascular Center of Sarasota Foundation for Research and Education, Sarasota
Clinical Site Partners, LLC DBA Flourish Research, Winter Park
GeorgiaAtlanta Clinical Research Centers, Atlanta
NSC Research, Inc, Johns Creek
IndianaIndiana Medical Research, Merrillville
LouisianaMonroe Research, LLC, West Monroe
MichiganProfound Research, Cardiology and Vascular Associates (CAVA) - Bloomfield Hills, Bloomfield Hills
Profound Research, Millennium Cardiology, Farmington Hills
AA Medical Research Center (MRC), Flint
New YorkSuper Health Pharmacy, Staten Island
North CarolinaHawthorne Health, Moose Pharmacy of Concord, Concord
OhioK&R Research LLC, Marion
South CarolinaAnMed Health, Anderson
South DakotaMonument Health Clinical Research, Rapid City
TennesseeTennessee Center for Clinical Trials, Tullahoma
TexasPharmaTex Research, Amarillo
PanAmerican Clinical Research, Brownsville
Southwest Family Medicine Associates, Dallas
East Texas Cardiology, Houston
Synergy Group Medical,LLC, Houston
Synergy Groups Medical, Houston
Heart Institute of East Texas, Lufkin
Texas Institute of Cardiology PA, McKinney
Synergy Group Medical, LLC, Missouri City
VirginiaConquest Research, Vienna

Conditions

From ClinicalTrials.gov, data retrieved Sep 29, 2026. Each study sets its own eligibility; the study team decides who can join.