There is currently no FDA-approved treatment for Lp(a). This market resolves YES if at least one medication specifically designed to lower Lp(a) receives FDA approval by December 31, 2027. The medication must be approved for the indication of lowering Lp(a) levels, not merely as a secondary effect of another approved drug. Resolution will be verified through the FDA's official approval announcements or the FDA's drug database at https://www.fda.gov/drugs/novel-drug-approvals-fda.

Must be a medication. Lipoprotein apheresis does not count.

Background

Lp(a) is estimated to affect 64 million people in the United States and 1.4 billion people worldwide. Unlike other types of cholesterol particles, Lp(a) levels are 80-90% genetically determined, and lifestyle patterns such as diet and exercise have no effect on circulating lipoprotein(a), and traditional lipid-lowering agents, including statins and fibrates, have proven unsuccessful at lowering this lipid.

Pelacarsen, an antisense oligonucleotide discovered by Ionis Pharmaceuticals and licensed to Novartis, is furthest ahead in development. Olpasiran is another siRNA investigational agent currently in a phase 3 trial. Eli Lilly announced positive Phase 2 results for muvalaplin, an investigational once-daily oral medication that significantly reduced elevated Lp(a) levels in adults, with placebo-adjusted reductions up to 85.8%.

Considerations

Phase 3 trials will be crucial in determining the viability of lowering Lp(a) with such therapies and improving cardiovascular outcomes. While multiple candidates show strong efficacy in reducing Lp(a) levels, FDA approval requires not only demonstration of safety and efficacy in lowering Lp(a), but also evidence that this reduction translates to meaningful clinical benefit. Pelacarsen's owning company has indicated that they may begin regulatory submissions in the second half of 2026.