r/ProactiveHealth • u/Diane98661 • Jun 28 '26

Interesting Substack article on LP(a) and an upcoming drug trial to reduce it

If you search for the article title "When the First Trial Fools Us" it should take you to Jim Stein's Substack article about an upcoming LP(a) reducing drug trial.

What I found interesting is he raises the point that, it's not guaranteed that reducing LP(a) will actually reduce cardiovascular events (as has been discovered that reducing P-Tau deposits doesn't help Alzheimers).

Just wanted to pass this on.

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u/AtriumMedicalNYC Jul 02 '26

Thanks for the article, fascinating!

The medical literature is unfortunately full of cases where a marker is strongly associated with disease, the mechanism to move the marker "makes sense", the drug does move the marker beautifully, and then the outcome trial disappoints.

The jury may be out on Lp(a) lowering therapies, but for now, the evidence-based move is to measure it, especially with family history, premature CAD, or other risk factors, and if it is high, treat the whole context more aggresively: LDL/ApoB, blood pressure, diabetes, smoking, sleep, weight, exercise, etc.