Pelacarsen missed its primary endpoint in the Lp(a)HORIZON trial. Here’s what’s actually known, what two doctors think happened, and why I’m putting my own effort back into LDL and ApoB instead of waiting on an Lp(a) drug.
I do not take a statin. I got my ApoB to 59 with about 170 pounds of weight loss and a generic ezetimibe that runs me twenty dollars a month, so when a big statin trial reads out I have nothing invested in the answer. I have also written here about why most of the
The FDA approved Mounjaro today to lower the risk of heart attack, stroke, and cardiovascular death in adults with type 2 diabetes who are at high risk for those events. That is a real expansion, and for a lot of people it is genuinely good news. It is also going to be reported badly by
An ApoB of 60 mg/dL sits at about the 10th percentile of untreated American adults, lower than roughly nine of every ten, under even the goal the 2026 guideline reserves for its high-risk patients, and inside the range the longevity crowd treats as the destination. By every framework I can find, a 60 is a
An ApoB of 90 mg/dL is the most average result an American adult can get. ApoB is in effect a particle count: every particle that can push cholesterol into an artery wall carries exactly one copy of it. In the National Lipid Association’s percentile table for untreated US adults, 90 is the 50th percentile. Whether
My first ApoB result was 95 mg/dL, in May 2025. Labcorp flagged it high, because Labcorp’s reference range tops out at 90. Cleveland Clinic publishes a normal range for men of 66 to 133, so the same tube of blood at a different lab would have come back with no flag at all. Whether my
I priced one standalone ApoB test at thirteen services on the same day. The advertised prices start at $11; the checkout totals mostly start at $24.
MVX tracks mortality across several cohorts, but nobody has shown that lowering the score improves survival, or what a healthy person should do with the result.
ZEUS lowered inflammation exactly as designed and did not cut cardiovascular events. That weakens hs-CRP as something to treat, not as something worth measuring. Update, August 22, 2026: the people behind the colchicine trials have answered ZEUS, and a new UK Biobank analysis sharpens what IL-6 actually predicts. Both are covered at the end of
Both drugs block PCSK9 and cut LDL by about the same amount. Repatha is available now and cheap for most insured people. Lipfendra saves you the needle but asks for a daily fasting window, and its only published price is a list price.
