India Pharma Outlook Team | Tuesday, 03 November 2026
Lp(a) screening has gained attention after Novartis’ experimental heart drug pelacarsen reduced lipoprotein(a) levels by about 80% but failed to lower the risk of major cardiovascular events in its Phase 3 trial.
The result has renewed questions about whether reducing this genetically determined risk marker can prevent heart attacks and strokes.
For India, the development also highlights a separate preventive-care challenge: identifying people with elevated Lp(a), particularly among South Asians and translating existing recommendations for testing into wider clinical awareness and risk assessment.
This raises questions about identifying inherited risk much earlier.
Lipoprotein(a), commonly referred to as Lp(a), is a cholesterol-carrying particle whose levels are largely determined by genetics. Elevated Lp(a) is associated with an increased risk of atherosclerotic cardiovascular disease, including heart attacks and strokes.
The Cardiological Society of India (CSI) guidelines for dyslipidemia management report that approximately one in four South Asians have elevated Lp(a), compared with around one in five people globally.
This makes Lp(a) screening an important consideration in preventive cardiovascular care, particularly for individuals with a family history of premature coronary artery disease, familial hypercholesterolemia or unexplained cardiovascular events.
Identifying elevated levels can help clinicians refine cardiovascular risk assessment and consider more intensive management of other modifiable risk factors.
Also Read: World Heart Day 2026: 8 Ways to Protect Your Heart Every Day
The CSI clinical practice guidelines identify elevated Lp(a) as an inherited cardiovascular risk factor and recommend at least one measurement during a person's lifetime.
They also support cascade testing among family members in relevant high-risk situations, including families with elevated Lp(a), familial hypercholesterolemia or a history of premature coronary artery disease.
Conventional lipid profiles primarily focus on cholesterol parameters such as LDL cholesterol, while Lp(a) requires a separate measurement.
Wider awareness among clinicians and patients of lipoprotein(a) testing guidelines and their implementation in routine preventive healthcare remain important considerations.
Novartis and Ionis Pharmaceuticals developed pelacarsen as an investigational antisense oligonucleotide designed to reduce Lp(a) production in the liver. Although the drug substantially lowered Lp(a) levels in the Phase 3 Lp(a)HORIZON trial, it failed to meet its primary endpoint of reducing major cardiovascular events.
Currently, there are no approved therapies specifically targeting elevated Lp(a), making comprehensive cardiovascular risk management important for affected individuals.
For India, the setback reinforces the importance of identifying elevated lipoprotein(a) in South Asians while pharmaceutical companies continue investigating targeted treatments.
Until outcome evidence supports new therapies, Lp(a) screening, family-based risk identification and management of established cardiovascular risk factors remain important elements of preventive care.
.jpg)
