Opinion
Video
A Look to The Future of Lp(a) Management
Michael D. Shapiro, DO, and Erin D. Michos, MD, MHS, provide insights into upcoming Lp(a)-targeted treatments and current management strategies for improved cardiovascular outcomes.
This is a video synopsis/summary of an Insights involving Michael D. Shapiro, DO, and Erin D. Michos, MD, MHS.
Shapiro envisions exciting advancements in lipoprotein(a) (Lp[a]) management, particularly with targeted Lp(a)-lowering therapies like antisense oligonucleotides and small interfering RNA therapies. These novel agents, showing effectiveness in lowering Lp(a) by 80% to almost 100%, represent a major therapeutic breakthrough. Ongoing cardiovascular outcomes trials will determine the definitive impact on improved outcomes. Shapiro expresses optimism about the prospect of having medicines to dramatically lower elevated Lp(a), awaiting outcomes data to confirm risk reduction.
Erin D. Michos, MD, MHS, discusses actionable measures for Lp(a) today, emphasizing lifestyle, statin therapy, and aspirin for primary prevention. For high-risk individuals, she considers PCSK9 inhibitors, despite their primary indication for lowering low-density lipoprotein (LDL). Michos delves into emerging Lp(a)-targeted therapies in phase 2 or 3 trials, including pelacarsen and olpasiran, showcasing significant reductions. She anticipates results from the HORIZON and OCEAN(a) outcomes trials by 2025 and 2026, respectively. Michos also highlights other promising agents like lepodisiran, zerlasiran, and muvalaplin. Additionally, she notes lipoprotein apheresis as an available treatment option for severely elevated Lp(a) and recurrent vascular events. The future holds promise for transforming Lp(a) management with innovative therapies, pending robust evidence of improved cardiovascular outcomes.
Video synopsis is AI-generated and reviewed by AJMC® editorial staff.
