RNA therapeutics
Annual review names 2024 "the year of lipoprotein(a)" as three RNA-based Lp(a)-lowering agents advance through outcome trials (Arch Med Sci 2025)
Original title: 2024: The year in cardiovascular disease - the year of lipoprotein(a). Research advances and new findings
This year-in-review covers 2024's research advances on Lp(a), which affects as many as 1.5 billion people worldwide and is 70-90% genetically determined, making it an independent, causal risk factor for atherosclerotic cardiovascular disease and calcific aortic valve disease distinct from LDL cholesterol. With no approved Lp(a)-specific therapy yet available, the review highlights three RNA-based agents advancing through clinical development to test whether pharmacologically lowering Lp(a) reduces cardiovascular risk, potential outcomes that could reshape cardiovascular prevention strategy. The authors note that these drugs, once approved, will likely first be used in secondary prevention, leaving open questions about managing elevated Lp(a) in primary prevention, and flag that Lp(a)'s precise physiological function and pathogenic mechanisms remain incompletely understood despite the field's rapid pace.
Original abstract
Elevated plasma lipoprotein(a) [Lp(a)] levels, which occur in as many as 1.5 billion people worldwide, are an independent and causal risk factor for atherosclerotic cardiovascular disease and calcific aortic valve disease. Unlike low-density lipoprotein cholesterol, Lp(a) levels are approximately 70-90% genetically determined. Currently, no approved pharmacological therapies specifically target lowering Lp(a) concentrations. Several drugs, mainly RNA-based therapies, that specifically and potently lower Lp(a), are under investigation. Three of these new therapeutic agents are advancing through clinical development to evaluate whether reducing Lp(a) levels can decrease cardiovascular risk. The outcomes of these trials could potentially transform cardiovascular disease prevention strategies; however, once approved, the drugs will likely be used for secondary prevention, and ongoing strategies for managing elevated Lp(a) in primary prevention will be important. Lipoprotein(a) research is a rapidly evolving field, but unanswered questions remain concerning the physiological function of Lp(a) and its true pathogenic mechanisms. This review of Lp(a) research focuses on new findings and clinical trial results that appeared in 2024.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.