What hazard ratio for the primary endpoint will be reported for pelacarsen in the overall Lp(a)HORIZON population?

My most likely value for the reported overall-population hazard ratio is 0.95, because Novartis reported a missed primary endpoint without describing any favourable numerical trend.

Lp(a)HORIZON (NCT04023552) tested Novartis's antisense drug pelacarsen (licensed from Ionis) against placebo in about 8,300 patients with established cardiovascular disease and elevated lipoprotein(a). The primary endpoint, time to first expanded major adverse cardiovascular event, was tested in patients with Lp(a) of at least 70 mg/dL and in a subpopulation with Lp(a) of at least 90 mg/dL. On 4 September 2026 Novartis announced that the trial did not meet its primary endpoint, without disclosing the hazard ratio. Full results are scheduled as a late-breaking presentation at the American Heart Association Scientific Sessions on 7 November 2026. The size of the miss matters for the other Lp(a)-lowering drugs in development, notably Amgen's olpasiran and Eli Lilly's lepodisiran.

Resolves to the point estimate of the hazard ratio (pelacarsen versus placebo) for the primary efficacy endpoint (time to first expanded MACE) in the overall study population with Lp(a) of at least 70 mg/dL, as first presented by Novartis or the trial investigators (the AHA 2026 presentation, a simultaneous publication, or a Novartis press release). Figures for the at least 90 mg/dL subpopulation or other subgroups do not count. If the overall-population hazard ratio has not been publicly reported by 30 June 2027, the question is annulled.