Pharmaceutical companies are betting on a little-known form of cholesterol, Lp(a), to develop the next blockbuster heart drugs. This shift represents a major change in cardiology. Previously, the focus was largely on lowering LDL cholesterol. But recent studies have shown that Lp(a) poses a significant risk for heart attacks.
Lp(a) was first discovered in 1963. High levels of this cholesterol more than double the risk of heart attacks. An estimated one in five people worldwide have elevated Lp(a). Despite this, less than 1% of adults were tested for it in the U.S. in 2024.
Drug companies like Novartis, Amgen, and Eli Lilly are now in late-stage trials. They aim to determine if drugs that reduce Lp(a) can effectively protect against heart attacks. Novartis’ experimental drug, pelacarsen, is designed to lower Lp(a) levels. Early results show that these companies can slash Lp(a) by more than 80%.
This development has experts excited. Dr. Steve Nissen remarked, “We thought raising HDL would be beneficial and that didn’t work, so I think we have to keep an open mind.” The clarity from population genetics supports this new direction. Jay Bradner stated, “The clarity of the signal from population genetics and the encouraging signs from earlier trials render this a very smart bet.”
Yet uncertainties remain. The exact amount Lp(a) needs to be lowered to prevent heart attacks is still unknown. Additionally, the timeline for Amgen’s pivotal trial results has been pushed back, creating questions about its effectiveness.
Leading cardiology organizations now recommend every adult be tested for Lp(a) at least once in their life. This recommendation could change how cholesterol testing is approached moving forward.
As research progresses, the financial stakes increase. Analysts predict Lp(a) drugs could generate $5.6 billion in annual sales by 2032. This potential market underscores the importance of these trials.
The upcoming years will be crucial for these pharmaceutical companies as they seek to validate their findings and bring new treatments to market. The expected year for Lilly’s Phase 3 trial data is 2029—this could redefine treatment protocols for those at risk of heart disease.
