Novartis announced after market close on Friday that its cholesterol drug Pelacarsen, co-developed with Ionis Pharmaceuticals, failed to significantly improve cardiovascular outcomes in late-stage clinical trials, despite lowering Lp(a) cholesterol levels. This setback has raised concerns about the prospects of competitors such as Amgen and Eli Lilly in the multi-billion dollar Lp(a) cholesterol-lowering drug development race. Following the news, Amgen's stock fell by approximately 5% in after-hours trading on Friday, Ionis Pharmaceuticals' stock dropped 10%, and Dutch NewAmsterdam Pharma's stock declined 12%. Analysts had previously estimated peak annual sales for Pelacarsen could reach $4 billion to $5 billion if successful.