September 4, 2026 · Lp(a) · Outcomes trial
Lp(a)HORIZON: pelacarsen did not meet its primary endpoint
What changed?
Novartis reported that pelacarsen lowered Lp(a) but did not significantly reduce the primary composite cardiovascular endpoint in the overall trial population.
What does the evidence actually show?
Lowering a biomarker is not, by itself, proof that a treatment improves clinical outcomes. Full peer-reviewed results and subgroup analyses are needed to understand the finding.
What does it not show?
This does not erase the observational and genetic evidence that elevated Lp(a) can mark higher cardiovascular risk. It also does not establish outcome benefit for pelacarsen.
Does this change practice today?
Continue to use Lp(a) as a risk-enhancing factor in overall prevention conversations. Do not present pelacarsen as an established outcome-improving therapy.
What should we watch next?
Peer-reviewed trial publication, prespecified subgroup results, safety data, and outcomes from other Lp(a)-lowering programs.