RecruitingPhase 3NCT07181109

Zilebesiran in Patients With Hypertension Not Adequately Controlled and With Either Established Cardiovascular Disease or High Risk for Cardiovascular Disease

ZENITH: A Phase 3 Global, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Zilebesiran in Addition to Standard of Care in Reducing Major Adverse Cardiovascular Events in Adult Patients With Hypertension Not Adequately Controlled and With Either Established Cardiovascular Disease or High Risk for Cardiovascular Disease


Sponsor

Alnylam Pharmaceuticals

Enrollment

11,000 participants

Start Date

Sep 22, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to evaluate whether zilebesiran versus placebo reduces the risk of cardiovascular (CV) death, nonfatal myocardial infarction (MI), nonfatal stroke, or heart failure (HF) events. This is an event-driven study that will continue until the targeted number of positively adjudicated primary endpoint clinical outcome events (COEs) have been reached.


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Is 18 years or older for patients with established cardiovascular disease (CVD)
  • Is 55 years or older for patients with high risk for CVD
  • Has established CVD (defined as coronary, cerebrovascular, or peripheral artery disease) or high risk for CVD
  • Has treated hypertension on stable therapy with at least 2 standard of care antihypertensive medications, one of which must be a thiazide, thiazide-like, or loop diuretic

Exclusion Criteria7

  • Has known history of secondary hypertension
  • Has symptomatic orthostatic hypotension
  • Has alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \>3×upper limit of normal (ULN)
  • Has total serum bilirubin \>1.5×ULN
  • Has international normalized ratio (INR) \>1.5
  • Has serum potassium \>4.8 mEq/L
  • Has estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73m\^2

Interventions

DRUGZilebesiran

Zilebesiran will be administered SC

DRUGPlacebo

Placebo will be administered SC


Locations(229)

Clinical Trial Site

Huntsville, Alabama, United States

Clinical Trial Site

Huntsville, Alabama, United States

Clinical Trial Site

Sheffield, Alabama, United States

Clinical Trial Site

Chandler, Arizona, United States

Clinical Trial Site

Gilbert, Arizona, United States

Clinical Trial Site

Glendale, Arizona, United States

Clinical Trial Site

Mesa, Arizona, United States

Clinical Trial Site

Phoenix, Arizona, United States

Clinical Trial Site

Phoenix, Arizona, United States

Clinical Trial Site

Sun City West, Arizona, United States

Clinical Trial Site

Tucson, Arizona, United States

Clinical Trial Site

Tucson, Arizona, United States

Clinical Trial Site

Little Rock, Arkansas, United States

Clinical Trial Site

Little Rock, Arkansas, United States

Clinical Trial Site

Beverly Hills, California, United States

Clinical Trial Site

Chula Vista, California, United States

Clinical Trial Site

Escondido, California, United States

Clinical Trial Site

Glendale, California, United States

Clinical Trial Site

Lancaster, California, United States

Clinical Trial Site

Long Beach, California, United States

Clinical Trial Site

Lynwood, California, United States

Clinical Trial Site

Newhall, California, United States

Clinical Trial Site

Northridge, California, United States

Clinical Trial Site

Pasadena, California, United States

Clinical Trial Site

San Diego, California, United States

Clinical Trial Site

San Dimas, California, United States

Clinical Trial Site

Tarzana, California, United States

Clinical Trial Site

Toluca Lake, California, United States

Clinical Trial Site

Vista, California, United States

Clinical Trial Site

Walnut Creek, California, United States

Clinical Trial Site

Boca Raton, Florida, United States

Clinical Trial Site

Brandon, Florida, United States

Clinical Trial Site

Fleming Island, Florida, United States

Clinical Trial Site

Hialeah, Florida, United States

Clinical Trial Site

Hollywood, Florida, United States

Clinical Trial Site

Jacksonville, Florida, United States

Clinical Trial Site

Jacksonville, Florida, United States

Clinical Trial Site

Jacksonville, Florida, United States

Clinical Trial Site

Leesburg, Florida, United States

Clinical Trial Site

Melbourne, Florida, United States

Clinical Trial Site

Miami, Florida, United States

Clinical Trial Site

Miami, Florida, United States

Clinical Trial Site

Miami, Florida, United States

Clinical Trial Site

Orlando, Florida, United States

Clinical Trial Site

Palm Springs, Florida, United States

Clinical Trial Site

Tampa, Florida, United States

Clinical Trial Site

Wellington, Florida, United States

Clinical Trial Site

Brunswick, Georgia, United States

Clinical Trial Site

Columbus, Georgia, United States

Clinical Trial Site

Conyers, Georgia, United States

Clinical Trial Site

Conyers, Georgia, United States

Clinical Trial Site

Fayetteville, Georgia, United States

Clinical Trial Site

Johns Creek, Georgia, United States

Clinical Trial Site

Lawrenceville, Georgia, United States

Clinical Trial Site

Suwanee, Georgia, United States

Clinical Trial Site

Thomasville, Georgia, United States

Clinical Trial Site

Hazel Crest, Illinois, United States

Clinical Trial Site

Oak Brook, Illinois, United States

Clinical Trial Site

Orland Park, Illinois, United States

Clinical Trial Site

Tinley Park, Illinois, United States

Clinical Trial Site

Avon, Indiana, United States

Clinical Trial Site

Evansville, Indiana, United States

Clinical Trial Site

Greenfield, Indiana, United States

Clinical Trial Site

South Bend, Indiana, United States

Clinical Trial Site

Valparaiso, Indiana, United States

Clinical Trial Site

Hutchinson, Kansas, United States

Clinical Trial Site

Topeka, Kansas, United States

Clinical Trial Site

Wichita, Kansas, United States

Clinical Trial Site

Wichita, Kansas, United States

Clinical Trial Site

Lexington, Kentucky, United States

Clinical Trial Site

Hammond, Louisiana, United States

Clinical Trial Site

Lafayette, Louisiana, United States

Clinical Trial Site

Opelousas, Louisiana, United States

Clinical Trial Site

Shreveport, Louisiana, United States

Clinical Trial Site

Zachary, Louisiana, United States

Clinical Trial Site

Baltimore, Maryland, United States

Clinical Trial Site

Baltimore, Maryland, United States

Clinical Trial Site

Beltsville, Maryland, United States

Clinical Trial Site

Bowie, Maryland, United States

Clinical Trial Site

Lanham, Maryland, United States

Clinical Trial Site

Rockville, Maryland, United States

Clinical Trial Site

Flint, Michigan, United States

Clinical Trial Site

Southfield, Michigan, United States

Clinical Trial Site

Troy, Michigan, United States

Clinical Trial Site

Troy, Michigan, United States

Clinical Trial Site

Richfield, Minnesota, United States

Clinical Trial Site

Jackson, Mississippi, United States

Clinical Trial Site

Olive Branch, Mississippi, United States

Clinical Trial Site

Port Gibson, Mississippi, United States

Clinical Trial Site

Kansas City, Missouri, United States

Clinical Trial Site

Kansas City, Missouri, United States

Clinical Trial Site

St Louis, Missouri, United States

Clinical Trial Site

St Louis, Missouri, United States

Clinical Trial Site

Fremont, Nebraska, United States

Clinical Trial Site

Bridgewater, New Jersey, United States

Clinical Trial Site

Albuquerque, New Mexico, United States

Clinical Trial Site

New Windsor, New York, United States

Clinical Trial Site

North Massapequa, New York, United States

Clinical Trial Site

Rosedale, New York, United States

Clinical Trial Site

The Bronx, New York, United States

Clinical Trial Site

West Seneca, New York, United States

Clinical Trial Site

Westfield, New York, United States

Clinical Trial Site

Durham, North Carolina, United States

Clinical Trial Site

Greenville, North Carolina, United States

Clinical Trial Site

High Point, North Carolina, United States

Clinical Trial Site

Fargo, North Dakota, United States

Clinical Trial Site

Beavercreek, Ohio, United States

Clinical Trial Site

Cincinnati, Ohio, United States

Clinical Trial Site

Cincinnati, Ohio, United States

Clinical Trial Site

Columbus, Ohio, United States

Clinical Trial Site

Dayton, Ohio, United States

Clinical Trial Site

Lima, Ohio, United States

Clinical Trial Site

Maumee, Ohio, United States

Clinical Trial Site

Edmond, Oklahoma, United States

Clinical Trial Site

Moore, Oklahoma, United States

Clinical Trial Site

Oklahoma City, Oklahoma, United States

Clinical Trial Site

Camp Hill, Pennsylvania, United States

Clinical Trial Site

Horsham, Pennsylvania, United States

Clinical Trial Site

Media, Pennsylvania, United States

Clinical Trial Site

Uniontown, Pennsylvania, United States

Clinical Trial Site

Columbia, South Carolina, United States

Clinical Trial Site

Greenville, South Carolina, United States

Clinical Trial Site

Chattanooga, Tennessee, United States

Clinical Trial Site

Chattanooga, Tennessee, United States

Clinical Trial Site

Knoxville, Tennessee, United States

Clinical Trial Site

Knoxville, Tennessee, United States

Clinical Trial Site

Amarillo, Texas, United States

Clinical Trial Site

Arlington, Texas, United States

Clinical Trial Site

Arlington, Texas, United States

Clinical Trial Site

Austin, Texas, United States

Clinical Trial Site

Beaumont, Texas, United States

Clinical Trial Site

Carrollton, Texas, United States

Clinical Trial Site

Dallas, Texas, United States

Clinical Trial Site

Duncanville, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Houston, Texas, United States

Clinical Trial Site

Humble, Texas, United States

Clinical Trial Site

Katy, Texas, United States

Clinical Trial Site

Kingwood, Texas, United States

Clinical Trial Site

Laredo, Texas, United States

Clinical Trial Site

McAllen, Texas, United States

Clinical Trial Site

McKinney, Texas, United States

Clinical Trial Site

McKinney, Texas, United States

Clinical Trial Site

Mesquite, Texas, United States

Clinical Trial Site

Missouri City, Texas, United States

Clinical Trial Site

Paris, Texas, United States

Clinical Trial Site

Plano, Texas, United States

Clinical Trial Site

Port Arthur, Texas, United States

Clinical Trial Site

San Antonio, Texas, United States

Clinical Trial Site

San Antonio, Texas, United States

Clinical Trial Site

San Antonio, Texas, United States

Clinical Trial Site

San Antonio, Texas, United States

Clinical Trial Site

Sherman, Texas, United States

Clinical Trial Site

Sugar Land, Texas, United States

Clinical Trial Site

Tomball, Texas, United States

Clinical Trial Site

Waco, Texas, United States

Clinical Trial Site

Bountiful, Utah, United States

Clinical Trial Site

Bountiful, Utah, United States

Clinical Trial Site

Layton, Utah, United States

Clinical Trial Site

Arlington, Virginia, United States

Clinical Trial Site

Danville, Virginia, United States

Clinical Trial Site

Newport News, Virginia, United States

Clinical Trial Site

Norfolk, Virginia, United States

Clinical Trial Site

Richmond, Virginia, United States

Clinical Trial Site

Suffolk, Virginia, United States

Clinical Trial Site

Suffolk, Virginia, United States

Clinical Trial Site

Winchester, Virginia, United States

Clinical Trial Site

Bellevue, Washington, United States

Clinical Trial Site

Castle Hill, Australia

Clinical Trial Site

Gosford, Australia

Clinical Trial Site

Merewether, Australia

Clinical Trial Site

Southport, Australia

Clinical Trial Site

Waitara, Australia

Clinical Trial Site

Brampton, Canada

Clinical Trial Site

Cambridge, Canada

Clinical Trial Site

Etobicoke, Canada

Clinical Trial Site

Greenfield Park, Canada

Clinical Trial Site

Lévis, Canada

Clinical Trial Site

Mirabel, Canada

Clinical Trial Site

Mississauga, Canada

Clinical Trial Site

Moncton, Canada

Clinical Trial Site

Scarborough, Canada

Clinical Trial Site

Toronto, Canada

Clinical Trial Site

Chikushino-shi, Japan

Clinical Trial Site

Chūōku, Japan

Clinical Trial Site

Chūōku, Japan

Clinical Trial Site

Fukuoka, Japan

Clinical Trial Site

Fukuoka, Japan

Clinical Trial Site

Hachiōji, Japan

Clinical Trial Site

Hakodate-Shi, Japan

Clinical Trial Site

Himeji, Japan

Clinical Trial Site

Izumi, Japan

Clinical Trial Site

Kasuga, Japan

Clinical Trial Site

Kita-ku, Japan

Clinical Trial Site

Kusatsu, Japan

Clinical Trial Site

Minamiku, Japan

Clinical Trial Site

Minato, Japan

Clinical Trial Site

Nagasaki, Japan

Clinical Trial Site

Osaka, Japan

Clinical Trial Site

Osaka, Japan

Clinical Trial Site

Saku, Japan

Clinical Trial Site

Sapporo, Japan

Clinical Trial Site

Shinagawa-Ku, Japan

Clinical Trial Site

Tamanashi, Japan

Clinical Trial Site

Yokosuka, Japan

Clinical Trial Site

Ebdentown, New Zealand

Clinical Trial Site

Hamilton, New Zealand

Clinical Trial Site

Silverdale, New Zealand

Clinical Trial Site

Birmingham, United Kingdom

Clinical Trial Site

Birmingham, United Kingdom

Clinical Trial Site

Bury St Edmunds, United Kingdom

Clinical Trial Site

Cardiff, United Kingdom

Clinical Trial Site

Chichester, United Kingdom

Clinical Trial Site

Corby, United Kingdom

Clinical Trial Site

Glasgow, United Kingdom

Clinical Trial Site

Ilford, United Kingdom

Clinical Trial Site

Leeds, United Kingdom

Clinical Trial Site

Liverpool, United Kingdom

Clinical Trial Site

London, United Kingdom

Clinical Trial Site

Manchester, United Kingdom

Clinical Trial Site

Penzance, United Kingdom

Clinical Trial Site

Poole, United Kingdom

Clinical Trial Site

Teeside, United Kingdom

View Full Details on ClinicalTrials.gov

For the most up-to-date information, visit the official listing.

Visit

NCT07181109


Related Trials