Pharmaceutical companies are betting on a lesser-known form of cholesterol, Lp(a), to develop potentially blockbuster heart drugs. This shift comes as Lp(a) has emerged as a significant risk factor for heart attacks.
Before this development, the medical community largely overlooked Lp(a). Traditional cholesterol treatments focused primarily on LDL and HDL levels. However, research has shown that high levels of Lp(a) can more than double the risk of heart attacks.
As of early Tuesday, Novartis, Amgen, and Eli Lilly are in late-stage trials testing drugs that target Lp(a). These companies have demonstrated that their experimental drugs can slash Lp(a) levels by more than 80%.
An estimated one in five people worldwide have elevated Lp(a). Yet, less than 1% of adults were tested for it in the U.S. in 2024. This alarming statistic highlights a gap in cholesterol testing and awareness.
Dr. Steve Nissen stated, “We thought raising HDL would be beneficial and that didn’t work, so I think we have to keep an open mind.” His perspective reflects the changing landscape in cardiology as researchers explore new avenues for treatment.
Jay Bradner emphasized the importance of genetic studies. He remarked, “The clarity of the signal from population genetics and the encouraging signs from earlier trials render this a very smart bet.” This insight supports the growing interest in Lp(a) as a target for therapeutic intervention.
However, uncertainties linger. The exact levels of Lp(a) that need to be lowered to prevent heart attacks are not known. Additionally, timelines for results from Novartis’ trial have been delayed due to slower-than-expected heart attack occurrences.
Looking ahead, Lilly expects to share data from its Phase 3 trial of lepodisiran in 2029. The potential annual sales for these drugs could reach $5.6 billion by 2032 if successful.