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. 2025 Jul 9;38(5):783-786.
doi: 10.1080/08998280.2025.2524791. eCollection 2025.

Emerging pharmacological strategies in lipoprotein(a) reduction

Taha Mansoor  1 , Mahmoud Ismayl  2 , Sachin Parikh  3 , Vijay Nambi  4   5 , Salim S Virani  6 , Anurag Mehta  7 , Xiaoming Jia  4 , Abdul Mannan Khan Minhas  4
Affiliations

Emerging pharmacological strategies in lipoprotein(a) reduction

Taha Mansoor et al. Proc (Bayl Univ Med Cent). .

Abstract

Background: Lipoprotein(a) (Lp(a)) is an low-density lipoprotein (LDL)-like particle whose elevation is considered a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. Currently, there are no published clinical trials showing whether Lp(a) lowering in conjunction with optimal LDL cholesterol control reduces ASCVD risk.

Methods: Clinicaltrials.gov, an online database for clinical research studies, was used to identify ongoing clinical trials studying targeted Lp(a) lowering pharmacotherapy as of May 2025. Twelve clinical studies met the criteria and were included in this summary.

Results: The three large, multicenter phase 3 outcome trials evaluating clinical cardiovascular disease endpoints of major adverse cardiac event (MACE) are Lp(a)HORIZON (NCT04023552), OCEAN(a) (NCT05581303), and ACCLAIM-Lpa(a) (NCT06292013), which investigate pelacarsen, olpasiran, and lepodisiran, respectively. Other phase 2 and phase 3 trials are also under way.

Conclusion: Results from upcoming trials will inform us whether Lp(a) reductions translate to improved cardiovascular clinical outcomes.

Keywords: Cardiovascular disease prevention; lipoprotein (a).

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Conflict of interest statement

The authors report no funding. Anurag Mehta, MD, has received grant funding from Novartis and Amgen. The other authors report no potential conflicts of interest.

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