COPENHAGEN — An experimental once-daily pill reduced blood levels of lipoprotein(a), an inherited particle linked to heart attacks and strokes that affects about one in five people, by an average of 86 percent in a trial of 9,800 patients, researchers reported on Monday, raising hopes for the first treatment for a risk factor that doctors can measure but have never been able to lower.
The drug, oxavaprim, developed by the Danish company Nordvand Pharmaceuticals, blocks the assembly of the particle in the liver. In the trial, published in a leading medical journal and presented at a cardiology congress in Amsterdam, 72 percent of patients taking the highest dose saw their levels fall below the threshold considered to carry elevated risk, compared with 3 percent of those on a placebo. Side effects, chiefly mild nausea and headache, were similar between the groups over the 18-month study.
“For 30 years we have told patients that they have a problem and that there is nothing we can give them for it,” said Dr. Kristian Holm-Nielsen, a cardiologist at Rigshospitalet in Copenhagen and the trial’s lead investigator. “Now we can at least say that the number can be changed. The next question, the only question that really matters, is whether changing the number changes the outcome.”
Lipoprotein(a), often written Lp(a), resembles the LDL particle known as bad cholesterol but with an extra protein attached that makes it stickier and more likely to promote clots and inflammation in artery walls. Levels are almost entirely determined by genes and are unaffected by diet, exercise or statins. An estimated 1.4 billion people worldwide have levels high enough to roughly double their risk of heart disease, and most have never been tested.
Several injectable drugs that silence the gene responsible are in late-stage trials, with the first results on heart attacks and deaths expected next year. Oxavaprim is the first oral drug to reach this stage, and analysts said a pill that could be taken at home, and manufactured cheaply, could reach far more of the people affected, particularly in countries without the cold chain that injectables require.
“A pill changes the public-health arithmetic entirely,” said Prof. Beatriz Lemos, a cardiologist at the University of Lisbon who was not involved in the trial. She cautioned that the history of cardiology was littered with drugs that improved a blood marker and failed to prevent events. “Lowering Lp(a) is biologically plausible. It is not yet proven. We should test more people and wait for the outcomes trial before we prescribe anything.”
Nordvand said a 14,000-patient trial measuring heart attacks, strokes and cardiovascular deaths is fully enrolled and expected to report in 2028. The company has not disclosed pricing. Jørgen Kaas, 62, a retired ferry captain from Helsingør who took part in the study, learned he had high Lp(a) after a heart attack at 54 that his doctors could not otherwise explain. “My father died at 58, my uncle at 61,” he said. “For the first time I have a number on a sheet of paper that is going down rather than up. Whether it saves me, I will find out the same way everyone else does.”
A version of this article appears in print on Oct. 12, 2026, Section A, Page 2 of the European edition with the headline: A Daily Pill Cut a Stubborn Inherited Heart Risk Factor by 86 Percent in a Large Trial.
