Good read about one of the two recent disappointments in cardiology, the failure Lp(a) lowering, with the other being IL-6. Hopefully CETP won't be next with the obicetrapib trial reading out in the next 6 months.
The Lp(a)HORIZON trial tested one of the most genetically validated targets in medicine, but failed to meet its primary endpoint of cardiovascular event reduction in secondary prevention.
While other therapeutic programs are also supported by genetic data, what was special about the Lp(a) hypothesis was that genetic estimates were used to predict the effect expected in trials, and these predictions partly informed the design of Lp(a)HORIZON.
The results therefore offer a unique opportunity to ask how well estimates from genetic studies translate into clinical risk reduction.
In this new piece (link in the comments), I go through the genetic evidence, the trial results, how they agree or disagree, and where this leaves the Lp(a) hypothesis.