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Lp(a) Heart Drug Misses Key Target in Trial

Adults with high Lp(a) should know that lowering the particle by 80% did not reduce heart attacks or strokes in this trial.

Updated on Nov. 2, 2026 in Heart Disease

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Novartis's experimental heart drug pelacarsen failed to reduce heart attacks and strokes in a Phase 3 trial despite cutting Lp(a) by 80%, sending shares down 16%. AI Illustration. Upload story photo >

Novartis's pelacarsen, an experimental drug targeting lipoprotein(a) [Lp(a)], did not meet its primary endpoint of reducing major cardiovascular events in a Phase 3 trial. The result sent Novartis shares down 16%, and the findings are relevant to adults who have been told their Lp(a) is elevated.

Why it matters

Lp(a) is a genetically influenced cholesterol-like particle that is not changed by diet, exercise, or lifestyle, so drugs that lower it were seen as a potential new prevention tool for heart disease. This negative result, the first large outcomes test of the class, shows that lowering Lp(a) by 80% did not translate into fewer heart attacks and strokes in this trial, which tempers expectations for the whole approach.

This was a randomized, placebo-controlled Phase 3 outcomes trial launched in 2019 that tested pelacarsen given monthly at 80 milligrams on top of statins and PCSK9 drugs. Although it lowered Lp(a) by 80%, it did not reduce the composite endpoint, and the full data are due for presentation at the American Heart Association meeting.

The players

Novartis

A Swiss pharmaceutical company developing pelacarsen, a drug aimed at lowering Lp(a) to reduce cardiovascular risk.

Amgen

A biotechnology company whose olpasiran, another Lp(a)-lowering therapy, is in Phase 3 testing.

Eli Lilly

A pharmaceutical company developing lepodisiran, an Lp(a)-lowering drug, in later-stage research.

American Heart Association

A leading U.S. nonprofit that sets heart health guidelines and hosts major cardiovascular research meetings.

American College of Cardiology

A major professional society for cardiologists that co-issued the recent guidance recommending Lp(a) testing for all adults.

The details

Lp(a) is a particle built from LDL-like cholesterol with an attached protein, and elevated levels are inherited because the liver produces too much of it. Pelacarsen works by binding to the messenger RNA that instructs the liver to make Lp(a), reducing production. In this trial, patients on pelacarsen also took LDL-lowering statins and PCSK9 drugs, and the primary endpoint combined death, heart attack, stroke, and the need for revascularization procedures. Doctors noted that including stroke in the composite was questionable because the link between Lp(a) and stroke is unclear.

Timeline

  1. The pelacarsen Phase 3 trial was launched in 2019.

  2. Earlier in 2026, the AHA and American College of Cardiology issued guidelines recommending that all adults have Lp(a) measured at least once.

  3. Full pelacarsen trial results will be presented Saturday in Chicago at the AHA annual scientific meeting.

  4. Amgen's Phase 3 olpasiran results are expected in early 2028.

  5. Eli Lilly's lepodisiran results are expected in 2029.

Health Landscape

Lp(a) has been a leading candidate for a new layer of heart-disease prevention beyond LDL cholesterol, and this trial is the first large outcomes test of an Lp(a)-lowering drug to report. Competing RNA-based therapies from Amgen and Eli Lilly, which lower Lp(a) by around 95%, will be judged against this result as their own data arrive.

If you have been told your Lp(a) is high, especially if heart disease runs in your family, this result means lowering the particle alone is not yet proven to prevent heart attacks and strokes. It is worth discussing with your doctor whether Lp(a) testing makes sense for you and what your overall risk plan should include.

The takeaway

Lowering Lp(a) by 80% did not reduce heart attacks and strokes in this trial, so treatments targeting this particle remain unproven. A practical next step is to ask your physician whether one-time Lp(a) testing, now recommended by major cardiology groups, fits your personal risk picture.

What happens next

Full pelacarsen trial results will be presented Saturday in Chicago at the AHA annual scientific meeting, and Amgen's olpasiran Phase 3 results are expected in early 2028.

Further reading

For broader background on how heart disease risk is assessed and treated, explore our Heart Disease section.

Source note: This article includes information reported by Medscape.