REGN7508 versus apixaban and enoxaparin for preventing blood clots after total knee replacement
Official title: A Phase 3, Multicenter, Randomized, Open-Label, Study to Evaluate REGN7508, A Factor XI Monoclonal Antibody, Versus Apixaban and Enoxaparin for Prophylaxis of Venous Thromboembolism After Elective Total Knee Arthroplasty (ROXI-APEX)
Run by Regeneron Pharmaceuticals · NCT07015905 · Data updated 2026-11-12
This trial will test whether REGN7508 prevents blood clots after elective one-sided total knee replacement in adults compared with apixaban, enoxaparin, or placebo.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 2000 (estimated) |
| Sponsor | Regeneron Pharmaceuticals Industry-sponsored |
| Locations | 47 sites (Sheffield, Alabama and 46 other locations) |
| Status | Recruiting |
| Started | June 25, 2025 |
| Main results expected | February 20, 2027 |
| Study ends | May 12, 2027 |
| Registry record updated | November 6, 2026 |
| Trial ID | NCT07015905 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults undergoing elective primary unilateral total knee replacement who meet protocol safety criteria (including weight ≤130 kg and acceptable kidney function) and have no recent bleeding or thromboembolic history are ideal candidates.
✕Probably not a fit
People with a history of thromboembolic disease or thrombophilia, recent major surgery or bleeding, or severe kidney impairment (eGFR <30 mL/min/1.73 m2) are unlikely to be eligible or to benefit from participation.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This Phase 3 randomized trial compares REGN7508, an investigational Factor XI–targeting drug, with standard anticoagulants apixaban and enoxaparin (and placebo) for preventing venous thromboembolism after elective unilateral total knee arthroplasty. Adults who meet weight, renal, and lab safety criteria and are undergoing primary unilateral TKA are randomized to a treatment arm and followed for post-operative VTE events, bleeding, drug levels, and anti-drug antibodies. Key exclusions include recent major surgery or trauma, recent significant bleeding, prior thromboembolic disease or known thrombophilia, and severe renal impairment. Multiple U.S. orthopedic clinical sites are enrolling participants and collecting safety and efficacy data.
Why it matters
Potential benefit: If successful, REGN7508 could offer an effective option to prevent post-knee-replacement blood clots with a different bleeding-risk profile than current anticoagulants.
How similar studies have gone: Other Factor XI–targeting agents have shown promising phase 2 signals of VTE prevention with potentially less bleeding, but confirmatory phase 3 evidence is limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Key Inclusion Criteria: 1. Is undergoing a primary elective unilateral TKA 2. Is in good health based on laboratory safety testing as described in the protocol 3. Body weight ≤130 kg at screening visit as described in the protocol Key Exclusion Criteria: 1. Any condition that, as assessed by the investigator, may confound the results of the study or pose an additional risk to the participant by study participation 2. History of bleeding in the 6 months prior to randomization requiring hospitalization or transfusion as described in the protocol 3. History of thromboembolic disease or thrombophilia 4. History of major surgery, including brain, spinal, or ocular, or major trauma within approximately the past 6 months prior to randomization 5. Has an estimated Glomerular Filtration Rate (GFR) of \<30 mL/min/1.73 m2 at the screening visit as described in the protocol Note: Other protocol-defined Inclusion/ Exclusion Criteria apply
Where it's running
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Shoals Medical Trials, Inc.
Sheffield, Alabama, United States Recruiting -
CARI Clinical Trials
Riverside, California, United States Recruiting -
Denver Metro Orthopedics, P.C. Englewood Location
Englewood, Colorado, United States Recruiting -
Delray Physician Care Center
Delray Beach, Florida, United States Recruiting -
Bioresearch Partner
Miami, Florida, United States Recruiting -
Sacred Heart Health System Inc
Pensacola, Florida, United States Recruiting
Show 41 more locations
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Gulfcoast Research Institute
Sarasota, Florida, United States Recruiting -
Phoenix Clinical Research
Tamarac, Florida, United States Recruiting -
Sinai Hospital of Baltimore, Inc.
Baltimore, Maryland, United States Recruiting -
Brigham and Women's Hospital
Boston, Massachusetts, United States Recruiting -
Curalta Clinical Trials
Westwood, New Jersey, United States Recruiting -
Duke University Health System (Duke Health), Duke University Hospital
Durham, North Carolina, United States Recruiting -
HD Research - First Surgical Hospital
Bellaire, Texas, United States Recruiting -
University of Texas (UT); Southwestern Medical Center
Dallas, Texas, United States Recruiting -
Futuro Clinical Trials
McAllen, Texas, United States Recruiting -
Flourish Research - San Antonio (Formerly Clinical Trials of Texas)
San Antonio, Texas, United States Recruiting -
DRx Clinical Research, LLC; South Texas Bone and Joint Institute
San Antonio, Texas, United States Recruiting -
DRx Clinical Research, LLC
St. George, Utah, United States Recruiting -
Multi-profile Hospital for Active Treatment Hearth and Brain EAD
Pleven, Bulgaria Recruiting -
Multiprofile Hospital for Active Treatment; Sveta Sofia EOOD (MBAL Sveta Sofia),
Sofia, Bulgaria Recruiting -
Szegedi Tudomanyegyetem; Albert Szent-Gyorgyi Clinical Center
Szeged, Csongrad-Csanad, Hungary Recruiting -
Gyor-Moson-Sopron Varmegyei Egyetemi Oktato Korhaz
Győr, Győr-Moson-Sopron, Hungary Recruiting -
University of Debrecen
Debrecen, Hajdú-Bihar, Hungary Recruiting -
Semmelweis University
Budapest, Hungary Recruiting -
Kansai Rosai Hospital
Amagasaki-shi, Hyōgo, Japan Recruiting -
Yuuai Medical Center
Tomigusuku, Okinawa, Japan Recruiting -
National Hospital Organization Osaka Minami Medical Center
Kawachi-Nagano, Osaka, Japan Recruiting -
Osaka Saiseikai Nakatsu Hospital
Kita-Ku, Osaka, Japan Recruiting -
Juntendo University Hospital
Bunkyo-ku, Tokyo, Japan Recruiting -
Saga University Hospital
Saga, Japan Recruiting -
Liepajas regionala slimnica; SIA
Liepāja, Latvia Recruiting -
Rigas 2 slimnica, SIA
Riga, Latvia Recruiting -
Hospital of Traumatology and Orthopaedics
Riga, Latvia Recruiting -
ORTO Klinika
Riga, Latvia Recruiting -
Vidzemes slimnica
Valmiera, Latvia Recruiting -
Lietuvos sveikatos mokslu universiteto Kauno ligonine
Kaunas, Lithuania Recruiting -
Lietuvos sveikatos mokslu universiteto ligonine Kauno klinik
Kaunas, Lithuania Recruiting -
Vsi Klaipedos Universitetine Ligonine
Klaipėda, Lithuania Recruiting -
Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie sp. z o.o.
Krakow, Poland Recruiting -
Samodzieny Publiczny Zaklad Opieki Zdorowotne (SP ZOZ) Centralny Szpital Kliniczny Uniwersytetu Medycznego w Lodzi - Hematology
Lodz, Poland Recruiting -
Ortopedyczno-Rehabilitacyjny Szpital Kliniczny im. Wiktora Degi Uniwersytetu Medycznego w Poznaniu
Poznan, Poland Recruiting -
Arensia Clinics S.R.L
Bucharest, Romania Recruiting -
ARENSIA Exploratory Medicine, County Hospital Cluj-Napoca
Cluj-Napoca, Romania Recruiting -
Keystone Clinical Studies LLC, dba Flourish Research
Plymouth Meeting, Pennsylvania, United States Withdrawn -
NextStage Clinical Research, All American Orthopedics and Sports Medicine
Houston, Texas, United States Completed -
University Multiprofile Hospital for Active Treatment "Prof. Dr. Stoyan Kirkovich"
Stara Zagora, Bulgaria Withdrawn -
Uniwersytecki Szpital Kliniczny nr.2 Uniwersytetu Medycznego w Lodzi
Lodz, Poland Completed
Study contacts
- Study coordinator: Clinical Trials Administrator
- Email: clinicaltrials@regeneron.com
- Phone: 844-734-6643
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.