Prevention & lipidsRandomised controlled trial
Pelacarsen and lipoprotein(a) apheresis in secondary prevention: the Lp(a)FRONTIERS APHERESIS trial
- Randomised controlled trial
- placebo-controlled
Authors' conclusion
Pelacarsen is a highly effective and well-tolerated Lp(a)-targeted therapy that substantially reduces the need for LA in patients with elevated Lp(a) and established CVD.
Study context
- Population
- Adults in Germany with Lp(a) >60 mg/dl and established cardiovascular disease (CVD) who had undergone ≥35 lipoprotein apheresis sessions in the prior year25 of 26 pelacarsen, 23 of 25 placebo completed
- Participants
- 51 adults
- Comparison
- Pelacarsen vs placebo
- Pelacarsenn = 26
- Placebon = 25reference
- Primary endpoint
- Rate of performed lipoprotein apheresis sessions normalised to the weekly schedule (actual/planned sessions)
- Follow-up
- 52 weeks
Primary result
Rate of lipoprotein apheresis
Odds ratio
0.006
95% CI 0.003–0.013
P < 0.0001
By group
Pelacarsen
0.16
mean
Placebo
0.93
mean
Pelacarsen vs Placebo
OR 0.006 (95% CI 0.003–0.013); P < 0.0001
As reported in the abstract
Secondary outcomes
| Outcome | placebo-adjusted change (%) (95% CI) | P value | |
|---|---|---|---|
| Placebo-adjusted Lp(a) change from baseline · week 52 | −72 (−79% to −61%) | P < 0.0001 | |
| −100−50050Difference, % (linear scale) |
| Outcome | Pelacarsen | Placebo | Estimate | P value |
|---|---|---|---|---|
| Time to lipoprotein apheresis avoidance (≥24 consecutive weeks) | median time 6.1 weeks | Not reported in the abstract | HR 88.3 | P = 0.0014 |
| Total lipoprotein apheresis avoidance · week 12 to week 52 | OR 163.2 | P = 0.0005 |
Safety
Injection site erythema (mostly mild)
Injection site erythema (mostly mild)
- Treatment-emergent adverse events similar between arms
Original publication
Pelacarsen and lipoprotein(a) apheresis in secondary prevention: the Lp(a)FRONTIERS APHERESIS trial. Eur Heart J. Published 21 February 2026. doi:10.1093/eurheartj/ehag073
Summarised from the published abstract; every number is checked against it