Novartis' Pelacarsen Fails to Reduce Cardiovascular Events Despite Lowering Lp(a) Levels in Phase III Trial

Results from the Phase III Lp(a) HORIZON trial, presented at the American Heart Association's Scientific Sessions 2026 and published in The New England Journal of Medicine, showed that Novartis' drug pelacarsen significantly reduced lipoprotein(a) (Lp(a)) levels by an average of 78%. However, despite this reduction, the drug did not lower the rate of major adverse cardiovascular events (MACE), such as heart attack or stroke, in patients with pre-existing cardiovascular disease and high Lp(a). The neutral findings suggest that targeting Lp(a) may be more complex than previously thought for preventing cardiovascular events.