Experimental Drug Shows Promise in Lowering "Stealthy Cholesterol" and Reducing Heart Disease Risk
For years, a silent threat has been lurking in the arteries of millions: lipoprotein(a), or Lp(a), often referred to as "stealth cholesterol." Unlike standard cholesterol, Lp(a) often goes undetected in routine tests and is largely unaffected by lifestyle modifications. But now, a promising experimental drug is offering new hope in the fight against this hidden cardiovascular risk factor.
Lp(a) is a genetic variant of LDL cholesterol that elevates the risk of heart attacks, strokes, and other cardiovascular diseases. Standard cholesterol tests typically don't measure Lp(a), and because there has not been effective treatments in the past, most doctors didn't check it. Approximately 1 in 5 people worldwide have elevated Lp(a) levels.
The experimental medication, lepodisiran, developed by Eli Lilly, works by targeting Lp(a) production in the liver. A recent clinical trial published in the New England Journal of Medicine revealed that the drug significantly reduced Lp(a) levels, offering potential for preventing heart disease related to high Lp(a).
In the Phase 2 trial, participants with high Lp(a) received either a placebo or varying doses of lepodisiran. Results showed substantial reductions in Lp(a) levels with the highest dose, with some patients experiencing a 95% drop. The drug also demonstrated good tolerability, with no major adverse reactions reported.
According to experts, Lp(a) presents a "triple hit" to heart health. It not only contributes to arterial plaque buildup but also promotes blood clot formation and inflammation, further exacerbating the risk of cardiovascular events. Importantly, Lp(a) levels are primarily determined by genetics, making them resistant to diet and exercise interventions.
While lepodisiran is not yet available to the public, the results of this study are considered very promising. Larger Phase 3 trials are currently underway to assess whether lowering Lp(a) with the drug will translate into fewer heart attacks and strokes. Other pharmaceutical companies are also developing drugs that target Lp(a).
Until targeted therapies become available, experts emphasize the importance of getting tested for Lp(a). A simple blood test can reveal your levels, and the National Lipid Association recommends that all adults get tested at least once.
If you are found to have high Lp(a), you and your doctor can focus on managing other modifiable risk factors for heart disease. This includes optimizing LDL cholesterol levels, blood pressure, weight management, diabetes control, and regular physical activity. Being proactive about these factors can help mitigate your overall risk.
Even without a specific treatment for Lp(a) currently available, knowing your levels empowers you to advocate for your heart health and work with your doctor to minimize risks.
