Novartis (NVS) and Ionis (IONS)’ Big Cholesterol Bet Comes Up Short in Late-Stage Trial

On September 5, 2026, Novartis AG and Ionis Pharmaceuticals announced that their experimental drug pelacarsen, aimed at reducing Lp(a) levels, failed to lower heart attacks, strokes, and related cardiovascular events in the Lp(a)HORIZON trial. The drug successfully lowered Lp(a) levels, but this reduction did not lead to fewer cardiovascular events.

Novartis shares dropped 5% and Ionis shares fell 12% in aftermarket trading. Novartis emphasized that the results were a disappointment but still contributed to scientific understanding of the Lp(a) pathway. The failure removes one potential blockbuster for Novartis, but the company has other promising pipeline opportunities, including remibrutinib, which recently succeeded in a late-stage multiple sclerosis trial.

Despite the setback, Ionis remains focused on its broader RNA-targeted medicines pipeline, with Zanvastro approval providing validation. The loss of pelacarsen's potential revenue impact underscores the importance of Novartis and Ionis maintaining strong growth drivers as patent expirations loom.