A new experimental drug, lepodisiran, is expected to protect millions of people from heart attacks and strokes by lowering a little-known risk factor in the blood. Made by pharmaceutical giant Eli Lilly, the drug lowers levels of a tiny particle known as Lp(a) by 94 per cent with a single shot, a new study has shown.

According to experts, Lp(a) is a mix of protein and lipids.

The research done on lepodisiran said its effects lasted six months with no major side effects. The study, presented in Chicago Sunday at an American College of Cardiology meeting, was also published in the New England Journal of Medicine.

“If further trials show that this medication - lepodisiran - is safe and can reduce strokes, it would be good news for patients because it eliminates a risk factor we’ve been unable to treat,” the lead study author, Steve Nissen, M.D., chief academic officer at the Heart, Vascular, and Thoracic Institute at the Cleveland Clinic in Ohio, earlier said in a statement. “This medication could be a once-a-year injection similar to a vaccine for people with high Lp(a) levels.”

Across the world, it is estimated that 20–30 per cent of people have elevated Lp(a) levels, generally considered to be above 30–50 mg/dL (or 125 nmol/L), and this is associated with an increased risk of heart diseases like heart attacks and stroke. Doctors say most people do not know they have it.

Doctors have hailed the profound and long-lasting reduction in lipoprotein levels with lepodisiran, calling it “thrilling.” However, scientists say further studies are also needed to confirm whether lowering Lp(a) also lowers the risk of heart attacks and strokes.

According to experts, Lp(a)—discovered in 1974—is mostly controlled by genes and is not regulated by diet and exercise. Those with slightly high levels have a 25 per cent greater risk of heart disease, and those with very high levels—around 10 per cent of people -- have double the risk.

Doctors say it is most often the hidden reason behind heart attacks in young or healthy people.

Dr. Steven Nissen, a preventive cardiologist at the Cleveland Clinic and involved in Lilly's lepodisiran trial, says whenever anyone younger than 40 years comes to hospitals with heart attack symptoms, their Lp(a) levels should be checked first. He added those with high Lp(a) need to treat all other heart risk factors, like cholesterol and blood pressure, as well.

According to scientists involved in the trial, lepodisiran, a small interfering RNA (siRNA), disables the messenger RNA involved in producing apolipoprotein (a), an important component in the Lp(a) particle. And so, it reduces the production of Lp (a).

Doctors say to beat a risk factor that is largely genetic, a highly effective approach is to interfere with the gene—and that is what lepodisiran is designed to do.

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