Lp(a)FRONTIERS EXPANSION

Presented in FS.12 at AHA 2026 (Monday 9 November) and published simultaneously in Circulation: Population Health and Outcomes. Lp(a)FRONTIERS EXPANSION, a US phase 3b randomised, double-blind, placebo-controlled trial, enrolled 423 Black/African American and Hispanic adults with established ASCVD and Lp(a) of 125 nmol/L or more (422 analysed: 282 pelacarsen 80 mg monthly, 140 placebo; 64.5 percent Black non-Hispanic, 30.1 percent non-Black Hispanic, 5.5 percent Black Hispanic; median baseline Lp(a) 232.7 versus 219.3 nmol/L). At week 52 the geometric mean ratio of Lp(a) to baseline was 0.14 (95 percent CI 0.12 to 0.16) with pelacarsen and 0.98 (0.80 to 1.20) with placebo; between-group ratio 0.14 (0.11 to 0.18), P less than 0.0001, an 86 percent placebo-adjusted reduction. Completion 90.1 and 91.4 percent; treatment-emergent adverse events 66.0 versus 61.4 percent, serious 17.0 versus 15.0 percent, discontinuation for adverse events 6.0 versus 3.6 percent. Pharmacologically consistent with Lp(a)HORIZON, which showed no clinical benefit from a 78 percent reduction; the trial's value lies in its enrolment of under-represented populations. The VESALIUS-CV health-economic analysis from the same session has no public figures yet.