Novartis said its experimental heart drug pelacarsen failed to reduce heart attacks, strokes, or deaths in a late-stage clinical trial, a setback that erased billions in market value from Novartis and rival drugmakers racing to treat the same underlying cholesterol condition.
Novartis shares fell as much as 14 percent following the announcement, while Amgen dropped about 10 percent and Eli Lilly fell roughly 2 percent as investors reassessed the odds facing similar drugs still in development at those companies. Ionis Pharmaceuticals, which co-developed pelacarsen with Novartis, saw its shares sink about 10 percent as well.
What was pelacarsen supposed to treat?
Pelacarsen targets lipoprotein(a), or Lp(a), a largely genetic form of cholesterol that raises cardiovascular risk and affects an estimated one in five people worldwide. Unlike traditional cholesterol, Lp(a) levels are barely affected by diet, exercise, or existing statin drugs, which is why pharmaceutical companies have spent years developing new drug classes aimed specifically at lowering it.
In the trial, pelacarsen did lower patients’ Lp(a) levels as intended, but that reduction did not translate into fewer cardiovascular events compared with a placebo group, raising a fundamental question about whether lowering Lp(a) numbers actually improves patient outcomes at all.
What happens now for competing Lp(a) drugs?
Amgen’s competing drug olpasiran faces the most direct comparison to pelacarsen, since both drugs work through a similar mechanism and target broadly similar patient populations, meaning a similar trial outcome for Amgen is seen as a real risk. Eli Lilly’s lepodisiran is being tested in a broader group of patients, including some without established cardiovascular disease, which analysts say could limit how directly Novartis’ failure predicts Lilly’s results.
The stock reaction reflects how much investor expectation had built up around Lp(a)-lowering drugs as a next major cardiovascular drug class, following years of research suggesting the biological rationale was sound even before any large outcomes trial had reported results.
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