In early September, a closely watched Phase 3 trial revealed that pelacarsen — a drug developed by Novartis and Ionis to target lipoprotein(a), a cholesterol particle long linked to heart disease — failed to deliver the cardiovascular risk reduction researchers had hoped for. The result is a reminder that the distance between biological promise and clinical proof is rarely as short as ambition suggests. For millions of patients carrying elevated Lp(a) levels without adequate treatment options, the wait for a meaningful answer grows longer, even as the scientific community is left to reckon wit