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Updated: Jan 9, 2026
06:47
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
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Lipoprotein(a) - treatments in development.
Brian Tomlinson1, Chak Fun Law1
1Faculty of Medicine, Macau University of Science & Technology, Macau, China.
Expert Opinion on Pharmacotherapy
|December 6, 2025
Summary
Novel therapies like pelacarsen and siRNA agents significantly lower lipoprotein(a) [Lp(a)], a key cardiovascular risk factor. Ongoing trials will determine the clinical benefit of reducing Lp(a) levels.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Genetics
Background:
- Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular diseases, including atheromatous cardiovascular disease and aortic valve stenosis.
- Current lipid-lowering drugs have minimal impact on elevated Lp(a) levels, necessitating new therapeutic strategies.
Purpose of the Study:
- To review novel therapies under development for reducing elevated Lp(a) levels.
- To focus on drugs in advanced stages of clinical development.
Main Methods:
- PubMed search to identify novel Lp(a)-lowering therapies.
- Review of drugs in advanced development phases, including antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs), and small molecules.
Main Results:
- N-acetylgalactosamine (GalNAc)-conjugated ASO pelacarsen and siRNA agents (olpasiran, lepodisiran, zerlasiran) demonstrate high safety and efficacy, reducing Lp(a) by 80-100%.
- Oral small molecule muvalaplin shows up to 65% Lp(a) reduction.
- Pelacarsen, olpasiran, and lepodisiran are in Phase 3 cardiovascular outcome studies, with results anticipated in 2026. Muvalaplin is also undergoing cardiovascular outcome assessment.
Conclusions:
- Several novel therapies show significant potential for lowering Lp(a) and may offer cardiovascular benefits.
- Further research is crucial to establish optimal baseline Lp(a) levels and target reduction percentages for clinical benefit, and to assess potential adverse effects of aggressive Lp(a) lowering.
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