A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With Cardiovascular Disease, Chronic Kidney Disease and Inflammation (ZEUS)
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.
Eligibility
Inclusion Criteria
- Estimated glomerular filtration rate (eGFR) 15 and below 60 mL/min/1.73 m^2 (using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation)
- Serum high-sensitivity C-reactive protein (hs-CRP) greater than or equal to 2 mg/L at screening (visit 1)
- 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:
- Documented history of MI
- Prior coronary revascularisation procedure
- Greater than or equal to 50% stenosis in major epicardial coronary artery documented by cardiac catheterization or CT coronary angiography
- Cerebrovascular disease defined as at least one of the following:
- Prior stroke of atherosclerotic origin
- Prior carotid artery revascularisation procedure
- Greater than or equal to 50% stenosis in carotid artery documented by X-ray angiography, MR angiography, CT angiography or Doppler ultrasound.
- Symptomatic peripheral artery disease (PAD) defined as at least one of the following:
- Intermittent claudication with an ankle-brachial index (ABI) below or equal to 0.90 at rest
- 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
- Prior peripheral artery (excluding carotid) revascularisation procedure
- Lower extremity amputation at or above ankle due to atherosclerotic disease (excluding e.g. trauma or osteomyelitis).
- a) Coronary heart disease defined as at least one of the following:
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 screening (visit 1).
- 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).