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Lp(a) Drugs in 2026: Status of Each Trial

No Lp(a)-lowering drug is FDA-approved yet, and none is likely before the outcome trials report. Registered completion dates run from 2028 for olpasiran to 2031 for muvalaplin. If your Lp(a) is high now, clinicians lower LDL and ApoB further with medicines already approved.

When will Lp(a) drugs be available?

Not before their outcome trials report, which is likely years away. ClinicalTrials.gov lists estimated completion dates of March 2028 for olpasiran, March 2029 for lepodisiran and March 2031 for muvalaplin. As of August 2026, zerlasiran had not reported starting an outcomes trial.

Lp(a) runs high in roughly 1 in 5 people and is mostly inherited. Today, PCSK9 inhibitors lower it modestly, by roughly 20 to 30%.

What happened with pelacarsen?

It lowered Lp(a) and missed its main goal. On September 4, 2026, Novartis announced that Lp(a)HORIZON, which enrolled 8,323 people with heart disease and high Lp(a), did not show a significant reduction in cardiovascular events versus placebo. Full results are expected at a medical meeting.

Pelacarsen is an antisense drug, a different technology from the siRNA drugs below. Their own outcome trials will test whether lowering Lp(a) prevents heart attacks and strokes.

Which Lp(a) drugs are still in trials?

Three siRNA injections and one pill are in, or ready for, large outcome trials. siRNA tells the liver to make less of the protein Lp(a) is built from.

  • Olpasiran (Amgen): the phase 3 OCEAN(a)-Outcomes trial enrolled 7,297 people and lists March 2028. In phase 2, higher doses lowered Lp(a) by more than 95%.
  • Lepodisiran (Eli Lilly): in the phase 2 ALPACA trial, a single high dose lowered Lp(a) by about 94% over six months. The phase 3 ACCLAIM-Lp(a) lists March 2029.
  • Zerlasiran (Silence Therapeutics): in phase 2, Lp(a) fell by about 81 to 86% on average over 36 weeks versus placebo, depending on dose.

What is muvalaplin, and is it available?

Muvalaplin is not available in 2026. It is a daily pill from Eli Lilly that blocks Lp(a) particles from assembling. In the phase 2 KRAKEN trial, it lowered Lp(a) by up to about 70 to 86% at 12 weeks versus placebo, depending on the lab method, and lowered ApoB by up to about 16%.

Its phase 3 outcomes trial, MOVE-Lp(a), started in September 2025 and lists March 2031. If it succeeds, it would be the first pill made specifically to lower Lp(a).

Is obicetrapib FDA approved?

No. Obicetrapib is a once-daily CETP inhibitor pill aimed mainly at LDL. As of May 2026, its maker expected European, UK and Swiss decisions in the second half of 2026. Its outcomes trial, PREVAIL, enrolled 9,541 people, with an interim analysis planned for late 2026 and results expected in early 2027.

What should I do if my Lp(a) or LDL is high today?

Lower LDL and ApoB further than you otherwise would, using medicines already approved: statins, ezetimibe and, when needed, a PCSK9 inhibitor such as Repatha, Praluent, Lerochol or Lipfendra. Ask your clinician about your goal.

You may also qualify for a trial. ClinicalTrials.gov lists recruiting phase 3 studies of olpasiran and lepodisiran, and an Amgen expanded access program for olpasiran for adults with high Lp(a) and cardiovascular disease. Eligibility rules apply. No Lp(a) drug has a coverage policy yet, so keep your Lp(a), LDL and ApoB results and medicine history on hand.

Trials in this guide

Each links to a plain summary with a quote from the PubMed abstract.

  • ALPACA (2025) · Lepodisiran · 320 peoplePrimary lipid endpoint met
  • KRAKEN (2025) · Muvalaplin · 233 peoplePrimary lipid endpoint met

Common questions

▸Is there an approved medication for high Lp(a)?

Not one designed to lower Lp(a). PCSK9 inhibitors lower it by roughly 20 to 30% as a side benefit. Drugs aimed at Lp(a) cut it by 70% to more than 90% in earlier trials, but none has FDA approval.

▸What is the difference between obicetrapib and the Lp(a) drugs?

Different targets. Obicetrapib is a daily CETP inhibitor pill aimed mainly at LDL. Olpasiran, zerlasiran and lepodisiran are siRNA injections that lower Lp(a). Muvalaplin is a daily pill that blocks Lp(a) particles from forming.

▸Will insurance cover an Lp(a) drug once one is approved?

No one can say yet. Coverage follows approval and the final label. Keep your results and medicine history so a future request or appeal has records behind it.

▸Can I get an Lp(a) drug now through a trial?

Possibly. ClinicalTrials.gov lists recruiting phase 3 trials and an Amgen expanded access program for olpasiran. Eligibility rules apply, so ask your clinician.

The full guideRead the complete, referenced version on Preval Health More detail, every study, and the date each figure was checked.

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Not medical advice. General education from published trials and drug labels, last updated October 2026. lipid.site is not a healthcare provider and cannot tell you what to take or change. Talk to your clinician before starting or stopping any treatment. If you have chest pain or other signs of a heart attack or stroke, call 911.