Lp(a) sparks biotech's next wave of cardiovascular drug development

Lipoprotein(a), a genetically driven molecule linked to heart attacks, strokes, and valve disease, is poised to become a major target in biotech as firms race to develop Lp(a)-lowering therapies using siRNA and ASO approaches. The pivotal Horizon trial of pelacarsen from Novartis/Ionis is expected to read out soon and could trigger a surge in Lp(a) testing and treatment if positive, though questions remain about its ultimate market size and whether primary prevention is feasible. Competition is intensifying, with Amgen, Lilly, AstraZeneca, and others pursuing more potent or oral options, suggesting a broad, high-stakes field regardless of Horizon's outcome.