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Lipoprotein(a)

Lipoprotein(a), written Lp(a), is a cholesterol-carrying particle in the blood. Novartis says its level is about 90% set by genes and little changed by diet or lifestyle. In September 2026 Novartis reported that a large outcomes trial of pelacarsen, a medicine that lowers Lp(a), did not meet its main goal of reducing heart events.

Also called Lp(a)

  • Biomarker
  • In this atlas

Overview

Technical summary

The Lp(a)HORIZON registry record (NCT04023552) lists the condition as Cardiovascular Disease and Lipoprotein(a). On 4 September 2026 Novartis announced that the trial missed its primary endpoint (see the claim), so Lp(a) lowering with pelacarsen has not been shown to lower cardiovascular events. The full data had not been presented when this record was written. The 90% figure is a sponsor statement in a press release. MeSH has a heading for the particle.

What is measured

Measure
Concentration of lipoprotein(a) in blood; the Lp(a)HORIZON sponsor describes thresholds of 70 and 90 mg/dL
Assay context
Blood test. The sources read give no assay details.

Interpretation

  • Effect Interventional Certainty not assessed

    Novartis reported topline results on 4 September 2026 for Lp(a)HORIZON, a phase 3 outcomes trial of pelacarsen in adults with elevated Lp(a) and established cardiovascular disease: pelacarsen, compared with placebo, missed the trial primary endpoint, a four-part composite of cardiovascular death, heart attack, stroke and urgent coronary revascularization with hospital admission. Lp(a) fell on pelacarsen, but across all participants this was not shown to cut cardiovascular risk. The release gives no numbers and says full results will be shown at a future scientific meeting. The registry lists 8323 participants and completion on 2026-07-16.

    Applies to Adult
    • Patients with elevated Lp(a) and established cardiovascular disease. Novartis describes two analysis populations for the primary endpoint: everyone with Lp(a) of 70 mg/dL or more, and a subgroup with 90 mg/dL or more. The registry gives ages 18 to 80 years and enrollment of 8323.
    • Global multicentre trial per the sponsor; site list not read
    • Global (sponsor wording); countries not read
    • Adult, 18 to 80 years (registry)
    Follow-up Not stated in the sources read. The registry gives completion on 2026-07-16.
    Certainty method
    Not assessed
    Limitations
    This is a sponsor topline press release, not a peer-reviewed paper, and it gives no counts, hazard ratios or intervals. A PubMed title search on 2026-10-14 found commentary but no results paper (fetch log rows cg-status-pubmed-lpahorizon.json and cg-status-pubmed-summary.json). The release reports no separate result for the subgroup with Lp(a) of 90 mg/dL or more, although the primary endpoint was defined in both the overall population and that subgroup. The result may be refined when the full data are presented. The finding is for pelacarsen, one Lp(a)-lowering medicine, in people with established disease, and does not by itself settle whether other Lp(a)-lowering approaches would work.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (10)

    1. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, paragraph 1, sentence 1 (endpoint statement, first part)
      How it applies
      Sponsor statement of the result and the first part of the composite.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    2. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, paragraph 1, sentence 1 (endpoint statement, second part)
      How it applies
      Rest of the primary endpoint wording.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    3. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, paragraph 1, sentence 2
      How it applies
      Lp(a) lowering reported by the sponsor.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    4. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, paragraph 2, statement of the Chief Medical Officer
      How it applies
      Sponsor interpretation.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    5. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, paragraph 3
      How it applies
      Full data not yet released.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    6. Supports Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD)

      Webpage · Novartis AG (company press release) · Edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.

      Locator
      Press release, dateline
      How it applies
      Date of the statement.
      Retrieved
      Source effective date
      2026-09-04
      Source state
      Current
      Snapshot hash
      c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad
      Reuse basis
      Company press release. Its reuse terms were not read, so they are unverified. Only the hash of the page is kept, and public text is cite_only: facts are stated in the atlas's own words with a link.

    7. Background Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28. · NCT: NCT04023552

      Locator
      protocolSection.identificationModule.officialTitle: "A Randomized Double-blind, Placebo-controlled, Multicenter Trial Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230)"
      How it applies
      Registry title: placebo-controlled, double-blind.
      Retrieved
      Source effective date
      2026-08-28
      Source state
      Current
      Snapshot hash
      f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929
      Reuse basis
      Registry record. The raw API JSON is committed. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read by a script, so the redistribution basis is unverified; any quotation stays short. The raw file is committed at research/snapshots/cg-ctgov-NCT04023552.json.

    8. Background Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28. · NCT: NCT04023552

      Locator
      protocolSection.identificationModule.officialTitle: "on Major Cardiovascular Events in Patients With Established Cardiovascular Disease"
      How it applies
      Registry title, population.
      Retrieved
      Source effective date
      2026-08-28
      Source state
      Current
      Snapshot hash
      f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929
      Reuse basis
      Registry record. The raw API JSON is committed. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read by a script, so the redistribution basis is unverified; any quotation stays short. The raw file is committed at research/snapshots/cg-ctgov-NCT04023552.json.

    9. Supports Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28. · NCT: NCT04023552

      Locator
      protocolSection.designModule.enrollmentInfo.count: "8323"
      How it applies
      Registry enrollment count.
      Retrieved
      Source effective date
      2026-08-28
      Source state
      Current
      Snapshot hash
      f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929
      Reuse basis
      Registry record. The raw API JSON is committed. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read by a script, so the redistribution basis is unverified; any quotation stays short. The raw file is committed at research/snapshots/cg-ctgov-NCT04023552.json.

    10. Supports Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28. · NCT: NCT04023552

      Locator
      protocolSection.statusModule.completionDateStruct.date: "2026-07-16"
      How it applies
      Registry completion date.
      Retrieved
      Source effective date
      2026-08-28
      Source state
      Current
      Snapshot hash
      f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929
      Reuse basis
      Registry record. The raw API JSON is committed. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read by a script, so the redistribution basis is unverified; any quotation stays short. The raw file is committed at research/snapshots/cg-ctgov-NCT04023552.json.

Record details

Record id
cardio:lipoprotein-a
Content hash
65850b154af6a81d57a8594100f37fb053916df5ac72574b69e3f9d81b659606