Overview

The primary objective of this trial is to demonstrate that maridebart cafraglutide is superior to placebo when given as an adjunct to standard of care with respect to reducing cardiovascular (CV) morbidity and mortality.

Eligibility

Inclusion Criteria

• Age ≥ 45 years at screening.
• BMI of ≥ 27 kg/m2 at screening.
• History of Atherosclerotic Cardiovascular Disease (ASCVD) as evidenced by at least one of the following:
  • Prior MI.
  • Prior ischemic stroke (may include ischemic stroke with hemorrhagic transformation).
  • Symptomatic peripheral arterial disease (PAD), as evidenced by intermittent claudication with ankle-brachial index (ABI) < 0.9 (at rest), or peripheral arterial revascularization procedure, or amputation due to atherosclerotic disease.

Exclusion Criteria

• History of any of the following within 60 days before screening: MI, hospitalization for unstable angina, coronary artery revascularization, coronary artery bypass graft surgery or other major cardiovascular surgery, stroke, or transient ischemic attack (TIA).
• New York Heart Association (NYHA) class IV HF at screening or hospitalization for HF within 60 days before screening.
• Type 1 DM, or any type of diabetes with the exception of T2DM or history of gestational diabetes.
• For participants with a prior diagnosis of T2DM at screening:
  • HbA1c > 10.0% (86 mmol/mol) at screening.
  • History of diabetic ketoacidosis or hyperosmolar state/coma within 12 months before screening.
  • One or more episodes of severe hypoglycemia within 6 months before screening and/or history of hypoglycemia unawareness.
  • History of proliferative diabetic retinopathy, diabetic maculopathy, or severe non-proliferative diabetic retinopathy.
• Use of any glucagon-like peptide-1 receptor agonist (GLP-1 RA), glucose-dependent

  insulinotropic polypeptide (GIP) agonists or antagonists, or amylin analogs within 90 days before randomization or planned use during the conduct of the study.

• History of chronic pancreatitis or history of acute pancreatitis in the 180 days before screening.
• Family (first-degree relative[s]), or personal history of medullary thyroid carcinoma (MTC), or multiple endocrine neoplasia syndrome type 2 (MEN-2).
• Calcitonin ≥ 50 ng/L (pg/mL) at screening.
• Acute or chronic hepatitis; signs and symptoms of any liver disease other than metabolic dysfunction-associated steatotic liver disease, or alanine aminotransferase (ALT) > 3.0 x the upper limit of normal (ULN), or total bilirubin (TBL) > 1.8 x ULN (for participants with a known diagnosis of Gilbert syndrome, direct bilirubin should be used instead of TBL).
• History of malignancy within the last 5 years before screening (except for the following treated with curative intent: non-melanoma skin cancer, breast ductal carcinoma in situ, cervical carcinoma in situ, or prostate cancer in situ).
• Participants of childbearing potential planning to become pregnant while on study or unwilling to use protocol-specified methods of contraception during treatment.