Mechanisms
Review poses the 10 biggest unanswered questions about Lp(a), from its physiological role to how best to use it as a risk marker (Curr Opin Clin Nutr Metab Care 2024)
Original title: The 10 essential questions regarding lipoprotein(a)
This review outlines and attempts to answer ten of the most pressing outstanding questions about Lp(a), one of the most atherogenic lipoproteins, at a point where selective Lp(a)-lowering therapies have reached late-stage clinical trials despite two decades of progress in understanding its pathophysiology. The authors note antisense oligonucleotide treatment is currently the most advanced approach, lowering plasma Lp(a) by 60% to 80%, alongside two small-molecule medications in earlier development with similar efficacy. Beyond cataloguing the field's open preclinical and clinical questions about Lp(a) metabolism and physiological role, the review also surveys therapeutic approaches spanning nutraceuticals, currently available lipid-lowering drugs, and emerging medications, and illustrates how Lp(a) can be used as a marker to better predict cardiovascular risk.
Original abstract
Purpose Of Review: Lp(a) is one of the most atherogenic lipoproteins, and significant progress has been made to understand its pathophysiology over the last 20 years. There are now selective therapies in late-stage clinical trials to lower Lp(a). Yet there are many outstanding questions about Lp(a). This review outlines 10 of the most burning questions and tries to answer some of them.
Recent Findings: Antisense oligonucleotide (ASO) treatment is currently the most advanced therapy to lower plasma Lp(a) by 60-80%. There are, however, also two small molecule medications in early stage of development with similar efficacy.
Summary: This review aims to answer important preclinical and clinical questions about the metabolism and physiological role of Lp(a) and also outlines possible therapeutic approaches with nutraceuticals, currently available lipid-lowering therapies and new medications. In addition, ways are illustrated to use Lp(a) as a marker to better predict cardiovascular risk.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.