TLDR
- Novartis stock fell over 3% Monday after its experimental drug pelacarsen failed a late-stage cardiovascular trial
- The Lp(a)HORIZON trial involved more than 8,000 patients and missed its primary goal of reducing heart attacks, strokes and cardiovascular deaths
- Pelacarsen did lower lipoprotein(a) blood levels, but this did not translate into fewer cardiovascular events
- The failure raises questions about rival Lp(a)-targeting drugs from Amgen and Eli Lilly, which use a different pathway
- Novartis year-to-date gains now sit at 14%, down from higher levels before Monday’s drop
Novartis stock fell more than 3% in European trading Monday after the company revealed its experimental heart drug pelacarsen failed to meet its primary goal in a major late-stage clinical trial. The drop cut the stock’s year-to-date gain to around 14%.
The trial in question is the Lp(a)HORIZON study, which enrolled more than 8,000 patients with elevated levels of lipoprotein(a), a cholesterol-carrying particle in the blood that is linked to heart disease.
Pelacarsen did succeed in lowering Lp(a) levels. But lower blood levels did not translate into fewer cardiovascular events, like heart attacks, strokes, or death.
Novartis suffers a second trial disappointment in one week when the Swiss pharma group’s heart drug fails in a final-stage study https://t.co/k2ndYe13JA
— Bloomberg (@business) September 7, 2026
That gap between a biomarker moving and actual patient outcomes is a tough result for any drug to recover from.
Chief Medical Officer Shreeram Aradhye acknowledged the disappointment, saying the results were “not what we hoped for,” but added the data still advances understanding of the relationship between Lp(a) lowering and cardiovascular risk.
Questions for Rival Drugs Too
The failure does not only affect Novartis. Amgen and Eli Lilly are both developing their own drugs that target Lp(a), though through a different biological pathway. The pelacarsen outcome raises questions about whether lowering Lp(a) alone is enough to protect the heart.
No drug specifically targeting lipoprotein(a) has been approved yet, despite elevated Lp(a) affecting roughly one in five people worldwide.
Pelacarsen was licensed by Novartis from Ionis Pharmaceuticals. It is an antisense oligonucleotide, meaning it targets the production of Lp(a) at its source.
More Pressure on the Pipeline
Analysts at Jefferies noted that the broader success of existing cardiovascular therapies, combined with the rise of GLP-1 obesity drugs, is raising the bar for new heart treatments to prove their value in outcome trials.
The trial failure also comes less than a week after Novartis paused eight trials of a separate experimental cell therapy for autoimmune and neurological disorders following the deaths of three patients.
Jefferies said recent positive data from a multiple sclerosis trial should help soften the blow for investors.
But the bank also noted that Novartis now faces pressure to deliver positive results from a drug it acquired through its $12 billion Avidity Biosciences deal to justify that price tag.
Full results from the Lp(a)HORIZON trial are expected to be presented at a future medical congress.
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