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Zilebesiran

Phase 3

High Risk Cardiovascular Disease | Small molecule | Cardiovascular |Alnylam Pharmaceuticals, Inc.|Last Updated: Aug 19, 2026

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment11,000

FDA Designations

No designations recorded

Clinical trial landscape

Zilebesiran · 3 trials · 4 indications

Phase 3 1Phase 2 1Phase 1 1
NCT07181109Zilebesiran in Patients With Hypertension Not Adequately Controlled and With Either Established Cardiovascular Disease or High Risk for Cardiovascular DiseaseHigh Risk Cardiovascular Disease
RECRUITING11,000 Analytics
PHASE3RECRUITING
Zilebesiran in Patients With Hypertension Not Adequately Controlled and With Either Established Cardiovascular Disease or High Risk for Cardiovascular Disease
High Risk Cardiovascular DiseaseUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to First Occurrence of a Composite Endpoint of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), Nonfatal Stroke, or Heart Failure (HF) Event (Hospitalization for HF or Urgent HF Visit)
Up to approximately 5 years
Change from Baseline at Month 3 in Mean Seated Office Systolic Blood Pressure (SBP)
Baseline and Month 3
Number of Participants With Adverse Events (AEs)
Up to 12 months

An AE is any untoward medical occurrence in a patient or clinical investigational subject administered a medicinal product and which does not necessarily have a causal relationship with this treatment.

Secondary Endpoints

Change from Baseline in Mean Seated Office Systolic Blood Pressure (SBP) at Month 6
Baseline and Month 6
Time to First Occurrence of a Composite Endpoint of CV Death, Nonfatal MI, or Nonfatal Stroke
Up to approximately 5 years
Composite Endpoint of CV Death and Total (First and Subsequent) HF Events (Hospitalization for HF or Urgent HF Visit)
Up to approximately 5 years
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Zilebesiran 300 mgEXPERIMENTALParticipants will be administered 300 mg zilebesiran subcutaneously (SC) once every 6 months as add-on therapy to their standard of care antihypertensive medications.
PlaceboPLACEBO_COMPARATORParticipants will be administered placebo SC once every 6 months as add-on therapy to their standard of care antihypertensive medications.
ZilebesiranEXPERIMENTALParticipants will receive zilebesiran on Day 1 of the 6-month double-blind (DB) treatment period. Participants must be on stable doses of at least 2, but not more than 4, antihypertensive medications for at least 30 days prior to screening and plan to remain on stable doses of these medications during screening and through the DB treatment period.

Interventions

NameTypeDescription
ZilebesiranDRUGZilebesiran will be administered SC
PlaceboDRUGPlacebo will be administered SC
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites1105

Inclusion Criteria: * 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...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaChileChinaColombiaCzechiaDenmarkFranceGermanyGreeceHungaryIndiaItalyJapanNetherlandsNew ZealandPolandPortugalRomaniaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwedenTaiwanTurkey (Türkiye)United KingdomPuerto RicoSwitzerland
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Recent Changes (Last 90 Days)

LOWAug 20, 2026NCT07181109lastUpdatePostDate: changed
LOWAug 20, 2026NCT07181109lastUpdatePostDate: changed
LOWAug 20, 2026NCT07181109lastUpdatePostDate: changed
LOWAug 20, 2026NCT07181109lastUpdatePostDate: changed
LOWJul 13, 2026NCT07181109lastUpdatePostDate: changed
LOWJul 13, 2026NCT07181109lastUpdatePostDate: changed
LOWJul 10, 2026NCT07181109lastUpdatePostDate: changed
LOWJul 10, 2026NCT07181109lastUpdatePostDate: changed
LOWJun 12, 2026NCT07181109lastUpdatePostDate: changed
LOWJun 12, 2026NCT07181109lastUpdatePostDate: changed

Frequently asked questions about Zilebesiran

What is Zilebesiran used for?

Zilebesiran is an investigational small molecule being developed for cardiovascular conditions, specifically for high risk cardiovascular disease, high cardiovascular risk, and mild to moderate hypertension. It is being studied as an add-on therapy in patients whose hypertension is not adequately controlled by standard of care antihypertensive medications.

How does Zilebesiran work?

Zilebesiran is a small molecule that belongs to the -siran (siRNA) target class. It is designed to interfere with gene expression at the RNA level, though the specific molecular target is not disclosed in the available information.

Who makes Zilebesiran?

Zilebesiran is being developed by Alnylam Pharmaceuticals, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol ALNY.

What phase is Zilebesiran in?

Zilebesiran is in Phase 3 clinical development. A Phase 3 trial (NCT07181109) is currently recruiting patients with hypertension not adequately controlled and with either established cardiovascular disease or high risk for cardiovascular disease. It is not FDA approved and remains investigational.

What clinical trials is Zilebesiran in?

Zilebesiran has been studied in several trials. A Phase 2 trial (NCT06272487) evaluated it as add-on therapy in high cardiovascular risk patients with hypertension. A Phase 1 trial (NCT06423352) studied it in Japanese patients with mild to moderate hypertension. A Phase 3 trial (NCT07181109) is currently recruiting.

Is Zilebesiran the same as KARDIA-3?

No, Zilebesiran is the drug being studied, while KARDIA-3 is the name of a clinical trial (NCT06272487) that evaluated Zilebesiran as add-on therapy in patients with high cardiovascular risk and hypertension not adequately controlled by standard of care antihypertensive medications.