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Olpasiran

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Olpasiran (development code AMG 890, formerly ARO-LPA[1]) is an investigational small interfering RNA (siRNA) therapy developed by Arrowhead Pharmaceuticals and licensed worldwide by Amgen. As of October 2025, it is in phase 3 trials to evaluate whether it reduces cardiovascular risk by lowering lipoprotein(a) (Lp(a)).[2] Olpasiran is under investigation to reduce major adverse cardiovascular events in patients with established atherosclerotic cardiovascular disease (ASCVD) and elevated Lp(a) concentrations, as well as for individuals at high-risk for a first cardiovascular event and elevated Lp(a) concentrations.[3]

In clinical trials, olpasiran was generally well tolerated. The most frequent adverse events were injection-site reactions,[4] which were usually mild.[5] No major safety signals emerged.[6]

Mechanism of action

Olpasiran is a N-acetylgalactosamine (GalNAc)–conjugated siRNA.[5] After uptake by hepatocytes through the asialoglycoprotein receptor,[7] the antisense strand is incorporated into the RNA-induced silencing complex (RISC),[5] which inhibits expression of the LPA gene. This reduces apolipoprotein(a) production and lowers circulating Lp(a).[4]

Olpasiran is a double-stranded siRNA[7] chemically modified for stability and conjugated with GalNAc[2] to enable hepatocyte targeting.[7]

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