Promising Heart Drug Fails in Trial, Stunning Doctors
Pelacarsen, an experimental Novartis injection, failed to prevent heart attacks, strokes or cardiovascular deaths in a large trial. Researchers reported the results Saturday.
- 78% average drop in Lp(a) levels, versus 13% with placebo.
- 12% of patients in each group had a serious cardiac event.
- 8,350 adults with prior heart disease were followed about five years.
- No subgroup, including patients with diabetes, showed a meaningful benefit.
Why it matters: Lp(a) is inherited and unaffected by diet or exercise, so a drug was the hoped-for fix. Cardiovascular disease kills more than 900,000 Americans each year.
- Lp(a) testing for every adult was recommended this year by the AHA and ACC.
- Novartis was among drugmakers promoting awareness of Lp(a) and the new testing guideline.
How 3 sources split on this story
Where they split: Cardiologists disagree on whether universal Lp(a) testing still makes sense without a proven treatment.
Center coverage, 1 sources: The center presents it as an unexpected scientific failure, emphasizing open questions and other drugs still being tested.
Left coverage, 2 sources: The left frames the result as a shock to cardiologists and a setback for preventive cardiology that also complicates the new push for Lp(a) testing.
What’s next: Rival drugs, including Lilly's lepodisiran and Amgen's olpasiran, are still in outcome trials. Results are expected over the next few years.
- Researchers are weighing explanations: treatment too late, too short, or in the wrong patients.
- Does high Lp(a) cause heart disease, or only mark another underlying risk?
- Would earlier or longer treatment, or patients with higher Lp(a), show a benefit?
- Will siRNA-based drugs succeed where pelacarsen's antisense approach did not?
