TL;DR
Current evidence supports strong biological efficacy, but definitive proof of clinical benefit awaits ongoing randomized cardiovascular outcomes trials, including Lp(a)HORIZON (pelacarsen), OCEAN(a)-Outcomes (olpasiran) and ACCLAIM-Lp(a) (lepodisiran).
This narrative review summarizes the molecular biology, genetics, epidemiology, pathophysiological mechanisms, and clinical relevance of Lp(a), and critically examines current and emerging therapeutic strategies aimed at reducing Lp(a)-mediated cardiovascular risk.
Emerging evidence links Lp(a) to atrial fi brillation, broadening its clinical relevance and integrating Lp(a) testing into risk assessment and preparing for targeted therapies are critical steps in modern cardiovas-cular prevention.
Novel unapproved therapies, including an antisense oligonucleotide, small interfering RNAs, and an oral small molecule have demonstrated Lp(a) reductions of up to 99% and are being tested in ongoing cardiovascular outcomes trials to determine whether pharmacologic Lp(a) lowering translates into reduced cardiovascular e...
Lipoprotein(a) [Lp(a)] is a genetically determined, apolipoprotein B-containing lipoprotein that contributes to cardiovascular risk through atherogenic, proinflammatory, and potentially antifibrinolytic mechanisms. Genetic, epidemiological, and mechanistic evidence supports a causal role for elevated Lp(a) in atheroscl...
The Lp(a) treatment landscape has moved from basic science to an active late-stage clinical pipeline and positive outcomes from these CVOTs could lead to regulatory approvals and guideline updates affecting hundreds of millions of high-risk patients globally.
Lipoprotein(a) [Lp(a)] is a predominantly genetically determined lipoprotein whose concentration is generally stable over time, although clinically relevant within-person variation can occur. Elevated concentrations affect about one in five people. It has emerged as one of the most important causal contributors to the...
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