Novartis confirmed delpacibart etedesiran missed the primary endpoint in a phase III trial for myotonic dystrophy type 1, adding to a week of clinical setbacks across its portfolio. The company said it will evaluate the full HARBOR dataset and engage with authorities on the next development path. In parallel, Novartis’ pelacarsen failed the primary cardiovascular endpoint in the phase III Lp(a)HORIZON trial, further clouding the company’s lipoprotein(a) strategy despite earlier biomarker reductions. Analysts interpreted the outcome as a meaningful setback for dedicated Lp(a)-lowering approaches. The combination of setbacks matters for biotech planning because it directly impacts capital allocation, partnering leverage, and how quickly internal pipelines are re-optimized. It also raises the stakes for continued focus on mechanism-linked biomarker strategies when clinical endpoints diverge from surrogate signals. For investors and development teams, the updates reinforce how rare-disease and cardiovascular programs can create outsized market volatility when confirmatory trials fail.