Pelacarsen lowered Lp(a) but did not reduce cardiovascular events

Pelacarsen did not reduce major cardiovascular events compared with placebo in people with established cardiovascular disease and elevated Lp(a), according to results of the Lp(a) HORIZON trial. The trial randomized 8,350 people to monthly 80 mg pelacarsen or placebo. A total of 8,322 were included in the efficacy analysis.

At a median follow-up of 4.7 years, the primary endpoint occurred in 12.3% of the pelacarsen group and 12.1% of the placebo group. The endpoint included cardiovascular death, nonfatal heart attack, nonfatal stroke or urgent coronary revascularization. Pelacarsen reduced Lp(a) by 77.7% at 12 months, but adverse events led to treatment discontinuation in 20.6% of the pelacarsen group and 7.5% of the placebo group.

Steven Nissen said the results apply to pelacarsen and patients receiving secondary prevention. Trials of other Lp(a)-lowering drugs are ongoing, and researchers are studying different populations, including people receiving primary prevention.