Lipoprotein(a), or Lp(a), is an inherited cholesterol-like particle that raises the risk of heart attack, stroke, and aortic valve disease — independently of LDL. About 1 in 5 people have elevated levels, but no drug has ever meaningfully lowered it. That is changing: the first dedicated Lp(a)-lowering medicines are now in late-stage trials.
What's actually going on in research
Several first-in-class drugs that switch off Lp(a) production are in Phase 3 trials, including pelacarsen (a monthly injection from Novartis), olpasiran (a longer-acting injection from Amgen), and muvalaplin (the first oral option, from Eli Lilly). These trials are measuring whether driving Lp(a) down by 70-90% actually prevents heart attacks and strokes — the answer over the next 1-2 years will reshape cardiovascular prevention. Smaller studies are exploring gene-editing approaches and the role of Lp(a) in aortic stenosis.
First Lp(a)-lowering drugs
Pelacarsen, olpasiran, and the oral pill muvalaplin are all in Phase 3 trials and have shown they can drive Lp(a) levels down by 70-90% in earlier studies. The next 1-2 years will reveal whether that translates into fewer heart attacks and strokes.
Oral options
Muvalaplin is the first pill that meaningfully lowers Lp(a) — a major step beyond the injectable approach, since most patients will likely need lifelong treatment. Other oral candidates are in earlier trials.
Cardiovascular outcomes data
Researchers are testing whether lowering Lp(a) prevents real-world cardiovascular events, not just lab values. The pelacarsen Phase 3 trial (Lp(a)HORIZON) and the muvalaplin Phase 3 trial are both designed to answer this question for people with established heart disease and high Lp(a).
What to know before you search
Eligibility usually depends on Lp(a) level (often above 70-90 mg/dL or 150-200 nmol/L), a history of cardiovascular disease, and current LDL-lowering medication.
What types of trials are currently open
- Treatment trials — Testing new Lp(a)-lowering drugs — both injections and pills — in people with elevated Lp(a).
- Cardiovascular outcomes trials — Measuring whether lowering Lp(a) actually reduces heart attacks, strokes, and other cardiovascular events.
- Screening studies — Identifying people with high Lp(a) earlier, often through family-history-driven testing or routine cholesterol panels.
- Observational studies — Tracking long-term cardiovascular outcomes in people with elevated Lp(a) to better understand how risk evolves.
- Combination trials — Testing Lp(a)-lowering drugs alongside existing cholesterol or blood-pressure treatments to see if combined strategies improve outcomes.
Recently added Lipoprotein(a) trials
Lipid Screening Study
The purpose of this pilot study is to estimate the prevalence of elevated Lipoprotein (a) in an adult primary care population and to describe the distribution of atherogenic lipid markers within this cohort. This pilot study will provide preliminary data to inform future cardiovascular risk assessment initiatives in primary care.
AI-assisted CT for Risk Stratification in Coronary Artery Disease (ACTION)
The goal of this observational study is to learn if AI-assisted cardiac CT imaging can improve cardiovascular risk stratification and prediction of future coronary events in an adult population undergoing clinically indicated cardiac CT. The main questions it aims to answer are: * Can AI-enhanced cardiac CT accurately assess cardiovascular risk in a real-world adult population? * How do CT-derived plaque characteristics correlate with clinical, biochemical, and lifestyle risk factors? Researchers will compare subgroups (e.g., patients with different risk profiles, biomarkers, or imaging findings, and a subset undergoing OCT imaging) to see if differences in imaging and clinical parameters are associated with cardiovascular risk and plaque vulnerability. Participants will: * Provide informed consent and medical history/demographic information * Undergo blood sampling for cardiovascular and metabolic biomarkers * Have a resting ECG performed * Complete a detailed lifestyle and health questionnaire * Receive a non-invasive cardiac CT scan interpreted by an expert * Potentially receive heart rate-lowering medication (e.g., metoprolol) if required for imaging quality * Be referred for further clinical evaluation if clinically indicated 
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