Lipoprotein(a), or Lp(a), is a cholesterol particle that raises heart attack and stroke risk regardless of LDL levels. About 20% of people have high Lp(a), determined almost entirely by genetics. Statins don't lower it, and until recently no drugs could.
What's actually going on in research
Trials are testing RNA-based drugs that dramatically lower Lp(a) to see if they prevent heart attacks and strokes. Researchers are also studying whether lowering Lp(a) reduces aortic valve disease, which high levels appear to accelerate. Several large outcome trials are now enrolling people with high Lp(a) and heart disease.
RNA silencing drugs
Pelacarsen and olpasiran are injected drugs that lower Lp(a) by 70-95%. Two large trials are testing whether this reduction prevents cardiovascular events in people with high Lp(a) and prior heart disease.
Aortic valve studies
High Lp(a) appears to accelerate calcification of the aortic valve. Trials are examining whether lowering Lp(a) slows this process and delays the need for valve replacement.
Biomarker studies
Research is clarifying which Lp(a) levels carry the highest risk and which populations benefit most from treatment. Studies are also testing whether lowering Lp(a) helps people without prior heart disease.
What to know before you search
Eligibility typically requires documented high Lp(a) levels, often above 70-125 nmol/L, and many trials require prior cardiovascular disease or evidence of atherosclerosis.
What types of trials are currently open
- Cardiovascular outcome trials — Testing whether lowering Lp(a) with new drugs reduces heart attacks, strokes, and death in people with high Lp(a) and existing heart disease.
- Aortic stenosis trials — Studying whether Lp(a)-lowering drugs slow the narrowing of the aortic valve in people with high Lp(a) and early valve disease.
- Prevention trials — Testing Lp(a)-lowering drugs in people with high levels but no prior cardiovascular events to see if early treatment prevents disease.
- Dosing and safety studies — Establishing optimal doses, injection schedules, and long-term safety of RNA-based Lp(a)-lowering drugs.
- Natural history studies — Following people with various Lp(a) levels over time to understand how the particle contributes to heart disease and valve problems.
Recently added Lipoprotein(a) trials
Try a low-carbohydrate diet to study how it affects your cholesterol
Ketogenic diets are very low-carbohydrate diets that increase hepatic production of ketone bodies, which have several effects as substrates and signals. Ketogenic diets are used to manage some conditions (e.g., drug-resistant epilepsy), and their potential for managing many other conditions (e.g., cancer) is being actively explored. Indeed, the British Dietetic Association acknowledge the potential for ketogenic diets to improve glycaemic control to a greater extent than some other diets in people with type 2 diabetes. A lower fasting glucose is also relevant to future mortality in people without diabetes. Ketogenic diets are popular in the general population, with up to 15% of the UK following a low-carbohydrate diet. There is, therefore, great interest in ketogenic diets amongst people with and without health conditions. However, although the diet shows promising results in improving blood sugar levels, it has also shown to increase low-density lipoprotein-cholesterol (LDL-c) in some individuals, which has been linked to increased cardiovascular health risks. The aim of this project is to find the potential for personalised use of (or guidance to avoid) ketogenic diets for cardiovascular disease risk. To do that the investigators will ask participants to replicate 24 hours of a ketogenic diet and a control diet thrice each. This will allow the investigators to find variability between responses and have a better idea of individuals who could benefit (or not) from following the ketogenic diet.
Take an injection being tested for high cholesterol treatment
The purpose of this study is to compare safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of the currently marketed formulation of inclisiran with a new formulation containing polysorbate 80 (PS80), after a single 284 mg subcutaneous (SC) administration.
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