A once-little-known lipid, lipoprotein(a), has taken the health space by storm over recent months. Sometimes called “stealthy cholesterol,” LDL cholesterol is a major driver of cardiovascular disease. This insidious poison that hardens the arteries and increases blood clotting, scientists now estimate leads to an early death of one in five people, worldwide. With an estimated 64 million Americans at risk of having high levels of Lp(a), most are still unaware of their elevated levels. Innovations in the field of treatment, particularly with the newest drug Lepodisiran, provide new optimism for those affected and at risk.
In individuals with high levels of Lp(a), these markers are associated with a higher inflammatory state and a higher risk of cardiovascular disease development. The National Lipid Association enthusiastically supports screening for Lp(a) in all adults at least once over the lifetime. This testing empowers patients to make more informed decisions about their cardiovascular risk.
Understanding Stealthy Cholesterol
Lipoprotein(a) is an unusual form of cholesterol that can build up in the arteries, causing dangerous plaque buildup. Unlike most other indicators of cardiovascular health, Lp(a) levels are set permanently very early on in a person’s life. This stability results in something rather powerful — once tested, there’s usually no need for re-testing.
Lp(a)’s stealthy reputation is part of what makes it so dangerous. Hundreds of thousands more people with high levels don’t know it, exposing them to serious, long-term health consequences. Dr. Corey Bradley, MD, notes that “we’ve never before had a way to lower it,” highlighting the historical challenges in managing this type of cholesterol.
The Risks Associated with High Lp(a)
High Lp(a) levels massively increase the risk of heart attacks and strokes. That’s because they encourage inflammation and blood clot formation. Given the potential for these rare adverse events, it is now more important than ever for individuals to know their Lp(a) status.
Further compounding the pain of high Lp(a) is its prevalence, with approximately 64 million Americans affected. Most do not show any symptoms until an acute cardiovascular crisis strikes. What’s more, everyone’s risk factors are different making knowing your risk factors key to preventing a case.
Dr. Steven Nissen, a prominent cardiologist, argues that we need to take more proactive steps to manage our health. He continues, “By removing these other variables from the equation, we can better protect people.” As we continue to develop more advanced therapies, he notes the need for early detection and monitoring.
Advances in Treatment: Lepodisiran
The recent approval of Lepodisiran marks a new era of effectiveness and safety for treating high Lp(a). This long-duration small interfering RNA drug very precisely targets lipoprotein(a), producing dramatic drops in levels. Clinical trials have indicated that Lepodisiran can reduce Lp(a) to undetectable levels for up to 9 months.
Clinical studies indicate that patients treated with the highest dose tested experienced the best results. On average, their Lp(a) levels fell 94%. In addition, four doses of Lepodisiran have been shown to be safe and tolerable within study participants.
Rest assured, Dr. Bradley is just as excited about this development for high-risk patients as you are. He calls it “a fantastic empowerment tool…a great opportunity for patients to get a sense of what their risk is and self-advocate.” With smart implementation, this breakthrough treatment has the potential to revolutionize how we prevent and treat cardiovascular disease.
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