Novartis’ pelacarsen failed to reduce cardiovascular death and emergencies in the Phase 3 HORIZON trial, the company disclosed. The experimental therapy, built in partnership with Ionis, targets Lp(a), a lipid-linked risk factor for major heart events. In the trial, pelacarsen did not beat placebo on the primary endpoint of reducing risk for heart attacks, stroke, or other major cardiovascular events. The result adds to the setbacks facing Lp(a)-lowering strategies, even as Lp(a) remains a widely studied target. The failure is expected to reshape Novartis’ near-term cardiovascular pipeline planning and could affect the durability of Lp(a) programs among developers that have built late-stage strategies around the same biology.