Failure of Novartis Lp(a) drug raises questions about cardiovascular strategy
Novartis’s experimental drug pelacarsen sharply lowered lipoprotein(a), a genetic cardiovascular risk factor carried by about one in five people, but did not reduce serious clinical events. In the Phase 3 HORIZON trial, participants followed for almost five years who were randomly assigned to pelacarsen or placebo showed no difference in heart attacks, strokes, urgent coronary revascularization, or deaths, even though Lp(a)—a mashup of lipids and proteins that at high levels can heighten the risk of severe heart problems—fell dramatically on the drug.
Full details were presented Saturday at the American Heart Association scientific sessions in Chicago and published simultaneously in the New England Journal of Medicine. Top-line results earlier this year had already shown that cutting Lp(a) failed to lower those outcomes, dealing a blow to a growing field of therapies aimed at the particle. The failure raises questions about cardiovascular strategies that treat Lp(a) as a target for preventing heart attacks, strokes, and deaths in people at genetic risk.
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