Trial
ALPACA (lepodisiran phase 2)
Status Completed, published NEJM 2025
320 participants with median Lp(a) of 254 nmol/L: lepodisiran 400 mg at baseline and day 180 lowered time-averaged Lp(a) by 93.9 percent from day 60 to 180 (placebo-adjusted) and by 94.8 percent from day 30 to 360; a single 400 mg dose held 88.5 percent over the year. Mild injection-site reactions in up to 12 percent, no drug-related serious adverse events. Presented at ACC.25.
Doses studied: 16, 96 and 400 mg at baseline and day 180, 400 mg then placebo, and placebo. Primary endpoint: placebo-adjusted time-averaged percent change in Lp(a) from day 60 to 180.
Page updated 17 August 2026.