On September 4, 2026, Novartis announced the topline results of its phase 3 Lp(a)HORIZON trial. Novartis shared that while pelacarsen lowered lipoprotein(a) [Lp(a)] levels, the trial failed to reduce the risk of major adverse cardiovascular events (MACE). The Lp(a)HORIZON trial enrolled 8,323 patients with elevated Lp(a) and established atherosclerotic cardiovascular disease (ASCVD) to assess whether pelacarsen (an antisense oligonucleotide targeting the apolipoprotein(a) mRNA) reduces the risk of a cardiovascular event in this population. The full clinical trial results are not yet available, but may yield further insight into treatment effect.

Lp(a) remains an important and independent risk factor for ASCVD. Clinicians and patients should continue to measure Lp(a). The 2024 NLA Scientific Statement on the Use of Lp(a) in Clinical Practice¹ and 2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia² recommend universal Lp(a) testing in all adults. Individuals with elevated Lp(a) should have ASCVD risk factors intensively managed to reduce their ASCVD risk, such as optimizing lifestyle habits and achieving low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol goals.

The Lp(a)HORIZON trial is the first of several clinical trials underway to test the impact of lowering Lp(a) on reducing MACE. Other current trials include:

• ACCLAIM-Lp(a) trial by Eli Lilly & Co., evaluating the impact of lepodisiran on the reduction of MACE in adults with elevated Lp(a) who have ASCVD or are at increased ASCVD risk. Lepodisiran is an injectable small interfering RNA (siRNA) therapeutic.
• OCEAN(a)-Outcomes trial by Amgen, evaluating the impact of olpasiran on the risk for coronary heart disease death, myocardial infarction, or urgent coronary revascularization in participants with coronary artery disease and history of myocardial infarction or revascularization and elevated Lp(a). Olpasiran is also an injectable siRNA therapeutic.
• OCEAN(a)-PreEvent trial by Amgen, evaluating whether Lp(a) reduction with olpasiran can prevent a first coronary artery disease event in individuals with elevated Lp(a) at high ASCVD risk.
• MOVE-Lp(a) trial by Eli Lilly & Co., evaluating the impact of muvalaplin on the reduction of MACE in adults with elevated Lp(a) who have experienced a previous ASCVD event or are at high ASCVD risk. Muvalaplin is an oral therapeutic that disrupts assembly of the Lp(a) particle.

For more information on Lp(a), visit:

• Clinician Resources from the National Lipid Association
• Patient Resources from the Foundation of the National Lipid Association

¹Koschinsky ML, Bajaj A, Boffa MB, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. Journal of Clinical Lipidology. 2024;18:e308–e319.

²Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2026;87:2624–2757.