RNA therapeutics
PCSK9 inhibitors and second-generation antisense oligonucleotides can now effectively lower Lp(a), though guidelines still stop short of recommending direct reduction, a review (Chonnam Med J 2021)
Original title: Recent Updates of Lipoprotein(a) and Cardiovascular Disease
This review by Liu, Yoon and Lee summarises recent epidemiological, genome-wide association, and Mendelian randomisation evidence linking elevated Lp(a) to coronary heart disease and cardiovascular disease. Despite Lp(a) being an independent ASCVD risk factor, current international clinical guidelines do not recommend directly lowering plasma Lp(a), mainly because no effective medicine specifically targeting it has been approved. The authors note that PCSK9 inhibitors and second-generation antisense oligonucleotides have recently been shown in clinical trials to effectively reduce plasma Lp(a), and the review covers Lp(a) structure, pathogenicity, prognostic evidence, and recent therapeutic advances.
Original abstract
In recent years, epidemiological studies, genome-wide association studies, and Mendelian randomization studies have shown a strong association between increased levels of lipoproteins and increased risks of coronary heart disease and cardiovascular disease (CVD). Although lipoprotein(a) [Lp(a)] was an independent risk factor for ASCVD, the latest international clinical guidelines do not recommend direct reduction of plasma Lp(a) concentrations. The main reason was that there is no effective clinical medicine that directly lowers plasma Lp(a) concentrations. However, recent clinical trials have shown that proprotein convertase subtilisin/kexin-type 9 inhibitors (PCSK9) and second-generation antisense oligonucleotides can effectively reduce plasma Lp(a) levels. This review will present the structure, pathogenicity, prognostic evidences, and recent advances in therapeutic drugs for Lp(a).
PCSK9 inhibitionRNA therapeutics
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.