Pharmaceutical companies are betting on a lesser-known form of cholesterol, Lp(a), to develop potentially blockbuster heart drugs. This focus could reshape treatment for cardiovascular disease.
Before this shift, the medical community largely overlooked Lp(a). Traditional cholesterol testing emphasized LDL and HDL levels. Yet, Lp(a) presents a more dangerous risk factor. People with high levels have more than twofold higher risk of heart attack compared to those without.
As of early Tuesday, Novartis, Amgen, and Eli Lilly are in late-stage trials testing drugs aimed at reducing Lp(a). These experimental medications have shown promise—demonstrating the ability to slash Lp(a) levels by over 80%.
Novartis’ drug pelacarsen is one such candidate. It aims to lower Lp(a) significantly. Meanwhile, Lilly expects to share results from its Phase 3 trial of lepodisiran by 2029.
Currently, only about 1% of adults in the U.S. were tested for Lp(a) in 2024. This lack of awareness may hinder early intervention for those at risk of heart attacks.
Dr. Steve Nissen emphasized the need for an open mind regarding cholesterol treatments. “We thought raising HDL would be beneficial and that didn’t work,” he stated. The clarity from genetics and encouraging trial signs make this a pivotal moment.
Experts like Jay Bradner view this as a smart investment for pharmaceutical companies. He noted that the data from population genetics supports the focus on Lp(a). Asad Haider added that Novartis’ trial could redefine how we understand this cholesterol’s impact.
The exact levels of Lp(a) required to prevent heart attacks remain uncertain. Additionally, slower than expected occurrences of heart attacks have delayed timelines for Novartis’ trial results. With an estimated $5.6 billion in annual sales projected by 2032, this area of research is critical for future cardiology advancements.
