RBD1119 in Coronary Artery Disease (CAD)

CAD is driven by atherosclerosis in the coronary arteries and is a major cause of myocardial infarction, heart failure, arrhythmias, and premature death. Despite contemporary secondary prevention including lipid lowering, revascularization when indicated, and antiplatelet therapy, participants with established CAD, particularly those post-ACS, remain at clinically meaningful residual risk of recurrent atherothrombotic events. Intensifying antithrombotic therapy can reduce ischemic events but typically increases bleeding, as exemplified by the addition of low dose rivaroxaban to aspirin in stable atherosclerotic disease. This persistent efficacy-safety trade-off supports development of antithrombotic approaches that reduce pathological thrombosis while preserving hemostasis. RBD1119 is a GalNAc-conjugated siRNA that targets factor XI mRNA in hepatocytes. The GalNAc moiety binds the asialoglycoprotein receptor on hepatocyte surfaces, enabling receptor mediated endocytosis and preferential hepatic uptake. Once internalized, RBD1119 mediates cleavage of factor XI mRNA via the RNA interference pathway, reducing hepatic factor XI expression and lowering circulating factor XI levels. This multicenter, randomized, double-blind, placebo-controlled, phase II trial will evaluate the PD, safety, and PK of subcutaneously administered RBD1119 in participants with stable coronary artery disease (CAD).