Novartis and Ionis Double Down on Lp(a)

Novartis and Ionis Pharmaceuticals doubled down on their Lp(a) alliance, launching a second collaboration focused on developing and commercializing a treatment for patients with lipoprotein(a)-driven cardiovascular disease. 

Novartis and Ionis are already deep into their initial Lp(a) alliance that led to the development of the antisense medicine, pelacarsen, which blocks the production of apolipoprotein(a), and is currently being evaluated in two Phase 3 trials and one Phase 2 trial.

  • That initial collaboration has already earned Ionis $275M in upfront and milestone-based payments since 2017, and could be with up to $900M.

Encouraged by pelacarsen’s progress and the potential of Lp(a) treatments, Novartis will give Ionis another $60M upfront and unspecified future payments for the right to develop, manufacture, and commercialize their second antisense-based Lp(a) therapy.

  • The companies believe that this follow-up antisense drug might offer even greater efficacy and dosing advantages, and have a better chance of becoming a leading Lp(a) treatment. 

Novartis and Ionis have good reason to continue their Lp(a) efforts, noting: 

  • It’s estimated that up to 20% of people have high Lp(a) levels
  • Elevated Lp(a) is strongly associated high higher CVD risks
  • Lp(a) can’t be controlled through diet and exercise
  • There’s still no effective and commercially-available Lp(a) treatments

That said, the companies could face plenty of competition by the time either of these drugs hits the market:

  • Verve Therapeutics and Lilly similarly teamed on Verve’s Lp(a) gene editing therapy 
  • Eli Lilly’s siRNA drug LY3819469 is in Phase 2 trials
  • Amgen’s olpasiran posted solid Phase 2 results and is now in Phase 3 trials
  • Silence Therapeutics’ RNAi-based Lp(a) drug is in Phase 2 trials

The Takeaway

Although we don’t currently have treatments for Lp(a), the efforts we’re seeing from Novartis, Ionis, and their competitors suggest that one might be on the way. And given Lp(a)’s potentially underappreciated role in CVD prevention, these efforts could prove worthwhile for the companies and their future patients.

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