Elevated lipoprotein(a) is an independent, genetically determined driver of cardiovascular disease for which weekly or biweekly lipoprotein apheresis has historically been the only available intervention. In the Phase 3 multicenter double-blind randomized Lp(a) FRONTIERS APHERESIS trial across 13 German hospital centers, patients with established cardiovascular disease undergoing weekly apheresis for high Lp(a) were randomized to subcutaneous pelacarsen (80 mg every 4 weeks) or placebo. Pelacarsen produced robust, sustained reductions in circulating Lp(a) and reduced the odds of requiring ongoing lipoprotein apheresis by >99% compared with placebo.

The safety profile was comparable to placebo, with transient injection-site reactions being the primary reported adverse event. Targeted antisense inhibition of apolipoprotein(a) offers a transformative pharmacological alternative that can…