Novartis pelacarsen flop shakes up Lp(a) drug bets for Amgen and Lilly

Novartis announced that pelacarsen, its antisense drug targeting Lp(a), failed to reduce cardiovascular events in the Phase III Lp(a)HORIZON trial, despite lowering Lp(a) levels, in a study of 8,323 patients with established cardiovascular disease. The primary endpoint—a composite of cardiovascular death, non-fatal heart attack, non-fatal stroke, and urgent revascularization—was not met versus placebo. The result raises questions about the broader Lp(a) reduction approach and adds pressure to Amgen and Eli Lilly’s competing programs; full data will be presented at an upcoming medical congress. Analysts say the Lp(a) hypothesis is weakened but not disproven, pending further data.