Pcsk9 inhibition 130 items
What evolocumab, alirocumab and inclisiran do to Lp(a) and to risk.
Trials, agents, guidance
Studies
- OCEAN(a)-DOSE: olpasiran lowers Lp(a) by more than 95 percent in patients with ASCVD (O'Donoghue et al., NEJM 2022)
- Alirocumab-induced Lp(a) lowering independently predicts fewer MACE after ACS: ODYSSEY OUTCOMES (Bittner et al., JACC 2020)
- Lp(a), PCSK9 inhibition and cardiovascular risk in FOURIER (O'Donoghue et al., Circulation 2019)
- Lp(a) predicts coronary events but not stroke, and evolocumab benefits at any Lp(a): VESALIUS-CV (Monguillon et al., Circulation 2026)
- Lp(a) and recurrent ASCVD in 273,770 US patients: risk rises continuously to a hazard ratio of 1.45 above 300 nmol/L (MacDougall et al., EHJ 2025)
- What existing lipid-lowering drugs do to Lp(a): meta-analysis of 147 RCTs (Xie et al., Atherosclerosis 2025)
- Lp(a) lowering by alirocumab reduces total cardiovascular events independent of LDL-C: ODYSSEY OUTCOMES (Szarek et al., EHJ 2020)
- Potent Lp(a) lowering with apo(a) antisense reduces pro-inflammatory activation of monocytes (Stiekema et al., EHJ 2020)
- Arterial wall inflammation persists in high-Lp(a) patients despite 60 percent LDL-C lowering with evolocumab (Stiekema et al., EHJ 2019)
- Oxidised phospholipids on apoB predict MACE after ACS and alirocumab abolishes the relation: ODYSSEY OUTCOMES (Tsimikas et al., Circulation 2025)
- Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia: A Randomized Clinical Trial
- The Spanish Society of Arteriosclerosis issues a consensus statement on lipoprotein(a), testing limitations, cardiovascular risk and treatment recommendations (Clin Investig Arterioscler 2024)
- Alirocumab cuts cardiovascular events regardless of sex, with a larger benefit at higher baseline Lp(a) in women, ODYSSEY OUTCOMES (J Clin Lipidol 2024)
- The Italian Society for the Study of Atherosclerosis publishes a national consensus on lipoprotein(a) testing and management (Nutr Metab Cardiovasc Dis 2023)
- The Australian Atherosclerosis Society issues a position statement recommending selective, not universal, Lp(a) screening for intermediate-to-high-risk patients (Heart Lung Circ 2023)
- Lp(a) reduction from PCSK9 inhibition does not independently lower cardiovascular events, a pooled analysis of 10 phase 3 alirocumab trials in 4983 patients (Atherosclerosis 2019)
- 2026 ACC/AHA guideline recommends universal one-time Lp(a) testing, review for endocrinologists on managing elevated levels (J Clin Endocrinol Metab 2026)
- Olpasiran tops a network meta-analysis of 51 trials (17,810 patients) ranking Lp(a)-lowering therapies against PCSK9 inhibitors (Diabetes Obes Metab 2026)
- Lp(a) and oxidised phospholipids track myocardial inflammation after heart attack in a PCSK9-inhibitor trial (Nat Cardiovasc Res 2026)
- PCSK9 inhibitors cut Lp(a) by up to 47%, umbrella review of twenty-one meta-analyses and 231,796 patients (Drugs 2026)
- Evolocumab stabilises coronary plaque more effectively in ACS patients with high Lp(a) than low, HUYGENS trial secondary analysis of OCT imaging finds (Eur J Prev Cardiol 2025)
- Alirocumab lowers both Lp(a) and LDL-C but they pull new-onset diabetes risk in opposite directions, cancelling out net effect, ODYSSEY OUTCOMES post-hoc analysis finds (Diabetes Care 2025)
- Olpasiran cuts Lp(a) by 92% in a network meta-analysis of 14 trials, outperforming non-targeted siRNAs like inclisiran, though zerlasiran raises injection-site safety flags (Diabetes Obes Metab 2025)
- Meta-analysis of randomised trials confirms PCSK9 inhibitor antibodies cut Lp(a) by an average of 27% (JACC Adv 2025)
- PACMAN-AMI substudy shows high baseline Lp(a) blunts plaque lipid-core regression despite alirocumab plus high-intensity statins (Circ Cardiovasc Imaging 2024)
- Mass, molar and mass-spectrometry Lp(a) assays predict cardiovascular risk and alirocumab benefit equally in 11,970 ODYSSEY OUTCOMES patients (Circulation 2024)
- PCSK9 inhibition lowers LDL cholesterol and Lp(a) discordantly in 20% of patients, a pooled analysis of 4 phase 3 evolocumab trials in 895 patients (J Am Heart Assoc 2019)
- PCSK9 monoclonal antibodies cut Lp(a) by 21.9% on average across 27 trials and 11,864 patients (Am J Cardiovasc Drugs 2019)
- Antisense drug IONIS-APO(a)Rx reveals standard LDL-C tests overestimate true LDL-C by up to 50% in high-Lp(a) patients, a phase 2 trial (J Clin Lipidol 2018)
- Alirocumab sustainably lowers Lp(a) by up to 29% over 1.5 years, a pooled analysis of 10 phase 3 ODYSSEY trials in 4915 patients (Am J Cardiol 2017)
- A PCSK9 loss-of-function mutation lowers Lp(a) and reduces aortic valve stenosis risk, a Danish study of 103 083 people (J Clin Endocrinol Metab 2016)
- Evolocumab cuts Lp(a) by up to 29.5%, a pooled analysis of 4 phase 2 trials and 1359 patients (J Am Coll Cardiol 2014)
- AMG145 (evolocumab) cuts Lp(a) by up to 32% in statin-treated patients, the LAPLACE-TIMI 57 phase 2 trial of 631 patients (Circulation 2013)
- No PCSK9-targeted agent beats another for lowering Lp(a), meta-analysis of thirty-one randomised trials (J Clin Lipidol 2026)
- PCSK9 inhibitors lower Lp(a) by about 17% in real-world practice, with a bigger effect at higher baseline levels and a smaller effect in women, multi-center study finds (Eur J Prev Cardiol 2025)
- Apo(a) isoform size, not baseline Lp(a), explains why PCSK9 inhibitor combination therapy lowers Lp(a) unevenly (CHORD study, J Clin Lipidol 2025)
- PCSK9 inhibitors cut MACE risk by 13% while lowering Lp(a) alongside LDL-C, meta-analysis of 12 RCTs and 48,116 coronary patients finds (Coron Artery Dis 2025)
- Gene-silencing drugs cut Lp(a) by 70-90% and LDL-C by over 30%, positioning PCSK9 and Lp(a) as the leading targets for RNA-based cardiovascular therapy, a review (Clin Ther 2023)
- Evolocumab 140 mg or alirocumab 150 mg every two weeks are the most effective PCSK9 inhibitor doses for lowering Lp(a), a network meta-analysis of 41 trials (J Cardiovasc Pharmacol 2023)
- Alirocumab and evolocumab cut Lp(a) by about 20% in familial hypercholesterolaemia, a meta-analysis of 11 RCTs and 2,408 patients (Endokrynol Pol 2023)
- PCSK9 inhibition Lp(a)-lowering effect explains under 4% of its coronary disease benefit, a Mendelian randomisation study of 310,020 UK Biobank participants (Atherosclerosis 2022)
- Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol
- PCSK9 inhibitors lower Lp(a) by 27%, with a bigger effect in the first 12 weeks than beyond, a meta-analysis of 64,107 patients across 41 trials (J Cardiovasc Pharmacol 2021)
- Alirocumab LDL-C and Lp(a)-lowering effects are discordant in 21.5% of patients, suggesting separate clearance pathways, a pooled analysis of 1,709 patients across 10 ODYSSEY phase 3 trials (Eur J Prev Cardiol 2021)
- VLDL-apoE production may drive Lp(a) synthesis, a kinetic study of PCSK9 mutation carriers and niacin-treated patients (Arterioscler Thromb Vasc Biol 2020)
- PCSK9 inhibitors lower Lp(a) by 15-30%, and FOURIER shows most benefit in patients with high baseline Lp(a), a review (Curr Opin Lipidol 2019)
- Adding PCSK9 inhibitors to niacin further lowers Lp(a) by about 15%, a retrospective analysis of 150 patients (J Clin Lipidol 2019)
- Evolocumab lowers Lp(a) by cutting production alone, but by speeding clearance when combined with atorvastatin, a kinetic trial of 63 men (Eur Heart J 2018)
- Combining PCSK9 inhibitors with apo(a) antisense therapy may best address residual risk in the 1 in 3 FH patients with high Lp(a), a review (Eur Heart J 2017)
- Diabetes lowers Lp(a) but raises PCSK9, and CETP inhibition with torcetrapib cuts Lp(a) by 11.1%, a clinical trial analysis (J Clin Lipidol 2018)
- Antisense therapy can cut Lp(a) by up to 90% in phase 1/2 trials, as three treatment approaches converge on the 'revenant' lipoprotein, a review (Eur Heart J 2017)
- PCSK9 and Lp(a) levels independently predict coronary calcium buildup in statin-treated FH patients, a study of 161 patients (Atherosclerosis 2016)
- Alirocumab slows cardiac graft vasculopathy only when LDL-C and Lp(a) are both raised, CAVIAR trial (JACC Heart Fail 2026)
- Only apheresis is FDA-approved for Lp(a) today, review of the RNA-therapeutics pipeline moving to phase 3 outcomes trials (J Clin Lipidol 2026)
- PCSK9 inhibitors lower Lp(a) by 20-30%, with tafolecimab strongest in East Asians, review (J Cardiovasc Pharmacol 2026)
- PCSK9 inhibition leaves monocyte subsets unchanged but Lp(a) composition tracks inflammatory monocytes after MI (Atheroscler Plus 2026)
- Olpasiran achieves more than 95% Lp(a) reduction in OCEAN(a)-DOSE, review of its pharmacology and trial data (Cardiovasc Hematol Disord Drug Targets 2026)
- Managing progressive ASCVD in patients with elevated Lp(a) despite optimal LDL-C control, review (Anatol J Cardiol 2026)
- Lipoprotein(a) levels in children with hypercholesterolemia
- Lp(a) independently predicts premature coronary disease 5-fold regardless of PCSK9, Malaysian cohort of 204 (Sci Rep 2026)
- Statins raise Lp(a) while PCSK9 and CETP inhibitors lower it, review of current and emerging therapies (Eur Cardiol 2026)
- Lp(a) and PCSK9 are markedly elevated in first ACS but don't track coronary severity, Indian cohort of 160 (Int J Cardiol Cardiovasc Risk Prev 2026)
- Imaging confirms Lp(a) drives high-risk coronary plaque features, from lipid-rich cores to thin fibrous caps, review synthesises (Rev Cardiovasc Med 2025)
- Statins and ezetimibe raise oxidized phospholipids on Lp(a) even as PCSK9 inhibitors leave them unchanged, 70-patient study finds (Atheroscler Plus 2025)
- PCSK9 inhibitors curb endothelial inflammation triggered by Lp(a) itself, not just LDL, in coronary artery cell culture, mechanistic study finds (BMC Cardiovasc Disord 2025)
- One in four clinicians never checks Lp(a), narrative review finds, blaming cost, isoform variability and thin treatment options for its clinical neglect (J Cardiovasc Dev Dis 2025)
- PCSK9 inhibitors cut post-PCI coronary slow flow and cardiovascular events in STEMI patients with CKD and elevated Lp(a), 323-patient study finds (Catheter Cardiovasc Interv 2025)
- Aggressive lipid-lowering achieved similar LDL-C targets regardless of Lp(a) level in 263 peripheral artery disease patients, with no excess amputation or death at high Lp(a) (Lipids Health Dis 2025)
- About a quarter of the world has Lp(a) above 50 mg/dL, and gene-silencing drugs dosed a few times a year could finally lower it robustly, a review (Curr Vasc Pharmacol 2024)
- Testing every adult once for Lp(a), cascade screening relatives, and PCSK9 inhibition on top of statins in high-risk patients, a clinical review (Prog Cardiovasc Dis 2024)
- Lp(a) risk rises above 30 mg/dL, with the accepted 50 mg/dL threshold, and levels can range beyond 1000 mg/dL, a pathophysiology and treatment review (Int J Environ Res Public Health 2023)
- Traditional Lp(a) drugs barely reach 50% reduction while new RNA-interfering agents may exceed 95%, a review of emerging pharmacotherapies (Int J Mol Sci 2023)
- Testing and treating Lp(a) is clinically actionable today via cascade screening and PCSK9 inhibition or apheresis, a review argues (Curr Cardiol Rep 2023)
- 20-25% of people worldwide have Lp(a) 50 mg/dL or above, and existing drugs barely touch it while three new agents in development could change that, a review (Pharmacotherapy 2023)
- Beyond statins and PCSK9 inhibitors, several non-lipid drug classes also alter Lp(a) levels, a review through January 2023 (Pharmaceuticals 2023)
- Inclisiran needs only two doses a year to sustain LDL-C lowering, with the ORION/VICTORION program also tracking its effect on Lp(a), a review (Pharmaceuticals 2023)
- Statins raise Lp(a) while PCSK9 inhibitors and RNA therapies lower it, a 57-year literature review of pharmacological effects on Lp(a) (Endocr Pract 2023)
- PCSK9 inhibitors and apheresis are the only current Lp(a)-lowering options proven to also cut cardiovascular risk, while ASOs and siRNAs may exceed 70% reduction, a review (Atherosclerosis 2022)
- Lp(a)-lowering could become the third pillar of lipid therapy alongside LDL-C and triglycerides, a Dutch perspective on eradicating lipid-driven cardiovascular risk (Neth Heart J 2022)
- Over 20% of the population has Lp(a) above 50 mg/dL, and antisense oligonucleotides can cut it by up to 90% as the Lp(a)HORIZON outcomes trial nears results, a review (Curr Atheroscler Rep 2021)
- Pelacarsen cuts Lp(a) by up to 80%, one of five RNA-targeted drugs reshaping dyslipidaemia treatment, a review (Curr Atheroscler Rep 2021)
- Lp(a) still predicts cardiovascular risk even when LDL-C is under 70 mg/dL, one of three residual-risk drivers alongside remnants and inflammation, a review (Clin Chem 2021)
- APO(a)Lrx (pelacarsen) can cut Lp(a) by up to 80%, far surpassing PCSK9 inhibitors, in patients where Lp(a) explains 5-20% of suspected FH diagnoses, a review (J Clin Med 2020)
- An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial
- The Effect of PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) Inhibition on the Risk of Venous Thromboembolism
- Peripheral Artery Disease and Venous Thromboembolic Events After Acute Coronary Syndrome: Role of Lipoprotein(a) and Modification by Alirocumab: Prespecified Analysis of the ODYSSEY OUTCOMES Randomized Clinical Trial
- Antisense apo(a) and apoB inhibitors could cut Lp(a) by up to 80%, a review of Lp(a)-lowering strategies for coronary disease (Drugs 2020)
- Lp(a) above 50 mg/dL raises cardiovascular risk, above 180 mg/dL matches familial hypercholesterolaemia, a review 57 years after Lp(a) discovery (Prog Cardiovasc Dis 2020)
- Antisense drug IONIS-APO(a)-LRX cuts Lp(a) by 90% in a phase 2 trial, a review of Lp(a) and atherosclerotic disease (Cardiovasc Drugs Ther 2019)
- Antisense drug AKCEA-APO(a)-LRx cuts Lp(a) by up to 80% as a phase 3 outcomes trial is planned, a review of antisense oligonucleotides for Lp(a) (Curr Atheroscler Rep 2019)
- Lp(a) correlates with PCSK9 levels only in patients with the low molecular weight apo(a) phenotype, a study of 205 patients with suspected familial hypercholesterolaemia (Atherosclerosis 2018)
- Lp(a)-lowering therapies cut levels by 25-30% in familial hypercholesterolaemia, though clinical benefit is unproven, a review (Curr Pharm Des 2018)
- Apheresis lowers Lp(a) by over 60%, while a phase 1 antisense drug reaches 88.8%, a review of Lp(a)-lowering options (Atheroscler Suppl 2017)
- Elevated Lp(a) above 50 mg/dL affects 1 in 5 people worldwide, a review of modern genomic insights into Lp(a) (Curr Opin Lipidol 2017)
- PCSK9 inhibitors show discordant LDL and Lp(a) responses in 40% of real-world patients, a study of 26 patients (J Clin Lipidol 2017)
- Hormone therapy cuts Lp(a) by up to 44% in postmenopausal women, more than niacin or PCSK9 inhibitors, a review of Lp(a) treatment options (Int J Clin Pract 2016)
- Elevated Lp(a) above 30 mg/dL affects 20-30% of the global population, a review of emerging Lp(a)-lowering therapies (Curr Opin Endocrinol Diabetes Obes 2016)
- One Lp(a) test can reclassify up to 40% of intermediate-risk patients, a review of Lp(a) re-emergence in clinical practice (Prog Cardiovasc Dis 2016)
- Apheresis cuts cardiovascular events by more than 80% in patients with elevated Lp(a), a review of lipoprotein apheresis and its future alongside PCSK9 inhibitors and antisense drugs (Med Devices (Auckl) 2016)
- Apheresis remains the only proven Lp(a)-lowering therapy in Europe, cutting levels by 60-70% per session, a review of current treatment options (Atheroscler Suppl 2015)
- Lipoprotein apheresis: From familial hypercholesterolemia and elevated lipoprotein(a) to emerging roles in peripheral arterial and renal disease
- Molecular Mechanisms and Therapeutic Targets of RNA-Based and Traditional Lipid-Lowering Agents in Residual Cardiovascular Risk: A Scoping Review of Key Directions Towards Future Perspectives
- From niacin to oral small molecules, review maps every strategy for lowering Lp(a) (J Clin Med 2026)
- PCSK9 gain-of-function gene variants show no measurable effect on lipids or arterial wall properties in statin-treated post-MI patients with severely elevated Lp(a) (Sci Rep 2025)
- Review traces why statins raise Lp(a) while PCSK9 inhibitors lower it, and what that means for residual cardiovascular risk (Clin Chim Acta 2025)
- OCEAN(a)-DOSE shows dose-dependent Lp(a) lowering with olpasiran every 12 weeks, part of a broader review of siRNA therapies for dyslipidaemia (Curr Atheroscler Rep 2023)
- PCSK9 inhibitors are currently the most effective approved option for lowering Lp(a), but measurement itself lacks a reference standard, a review with practical recommendations (Heart 2022)
- Lower Lp(a) predicts new-onset diabetes, but whether the link is truly causal remains muddled by conflicting Mendelian randomisation studies, a review (Atherosclerosis 2022)
- Despite decades of study, how the liver assembles and clears Lp(a) remains only partly understood, a comprehensive metabolism review (Atherosclerosis 2022)
- PCSK9 inhibitors modestly lower Lp(a) with cardiovascular benefit independent of LDL-C, while apheresis remains the most effective option, a review of modern approaches (Biomedicines 2021)
- No FDA-approved drug specifically lowers Lp(a) yet, but pelacarsen could change that, a clinical pharmacology review (Am J Cardiovasc Drugs 2022)
- APO(a)LRx leads the field of antisense oligonucleotides targeting Lp(a)-driven residual cardiovascular risk, a review (J Cardiovasc Pharmacol 2021)
- Statins, fibrates and bile acid sequestrants fail to lower Lp(a), leaving newer ASOs, CETP and PCSK9 inhibitors as the most effective options, a review (Am J Cardiovasc Drugs 2021)
- 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)
- PCSK9 inhibitors are the only current lipid drugs that both lower Lp(a) and reduce cardiovascular events, while niacin and CETP inhibitors fall short, a review (Vasc Health Risk Manag 2021)
- PCSK9 inhibitors remain the only drugs proven to reduce cardiovascular events partly via Lp(a), as gene-based therapies emerge, a review from pathophysiology to treatment (Ann Med 2020)
- People of African descent have the highest Lp(a) levels of any ethnicity, yet standardisation gaps hinder screening across diverse populations, a review (Cardiol Ther 2020)
- Mendelian randomisation confirms Lp(a) drives coronary disease, aortic stenosis, stroke and heart failure regardless of LDL control, a review revisiting two decades of evidence (Circ J 2020)
- Antisense apo(a) inhibitors could pair with statins for patients with both high Lp(a) and high LDL, as phase 3 data approaches, a review (Eur J Intern Med 2020)
- Lp(a) is shifting from a mere biomarker to a potential therapeutic target, a review of the evidence since its 1963 discovery (J Atheroscler Thromb 2019)
- Lp(a) is genetically fixed and diet-resistant, a review of its biology and response to statins, apheresis, PCSK9 and CETP inhibitors and antisense drugs (J Mol Cell Cardiol 2019)
- Whether lowering Lp(a) on top of statins reduces cardiovascular risk remains unproven, a review of PCSK9 inhibitors and antisense drugs (Curr Atheroscler Rep 2019)
- How PCSK9 antibodies lower Lp(a) remains unexplained, unlike statins which raise LDL receptor activity without lowering Lp(a), a review since 2012 (Clin Sci (Lond) 2017)
- Guidelines recommend Lp(a) screening but treatment options remain scarce, a review of Lp(a) as an independent cardiovascular risk marker (Clin Diabetes Endocrinol 2016)
- New drugs like apoB antisense, MTP and CETP inhibitors could finally test whether lowering Lp(a) helps, a review on when to measure Lp(a) (Eur Heart J 2013)
- Lipid-lowering therapy reduces oxidised-apoB immune complexes but not other oxidative markers in patients with Lp(a) 75 nmol/L or more (Clin Res Cardiol 2026)
- Doubling evolocumab frequency cuts Lp(a) 34.7% but leaves it markedly elevated, FH case report (Cureus 2026)
- A 53-year-old woman with Lp(a) of 492 nmol/L, family history and coronary disease needing stenting, started on a PCSK9 inhibitor (Cureus 2026)
- Evolocumab lowers LDL-C similarly across racial and ethnic groups, with Asian patients with diabetes seeing the largest reduction, a meta-analysis of 7,669 patients that also tracked Lp(a) (J Am Heart Assoc 2021)