Context:

Merck has developed a new pill, enlicitide, that significantly reduces LDL cholesterol levels by blocking the PCSK9 protein, potentially impacting millions of Americans at risk for heart disease. Initial trial results indicate that patients taking enlicitide experienced a 20% decrease in heart attack and stroke rates within a year, mirroring the effects of costly injectable alternatives. The goal is to make enlicitide affordable, as current injectable treatments are financially prohibitive for many, with only 1% of eligible patients utilizing them. With ongoing studies to confirm long-term benefits and plans for FDA approval in 2026, the medication could revolutionize cholesterol management. Experts view enlicitide as a potential game changer in cardiovascular health if priced accessibly.

Dive Deeper:

• Merck's enlicitide targets the PCSK9 protein, which, when inhibited, can lead to LDL cholesterol reductions of up to 60% in patients with a history of cardiovascular events.

• The initial trial included 2,912 participants and showed no significant side effects from enlicitide compared to a placebo, suggesting a favorable safety profile.

• Currently, approximately six million adults in the U.S. are eligible for PCSK9 inhibitors, but high costs and the nature of injections have limited treatment uptake.

• Merck's research team overcame previous challenges in developing an oral PCSK9 blocker by creating a peptide circle, which is smaller than antibodies used in current injectables.

• The projected launch of enlicitide is targeted for 2027, following a large-scale study involving over 14,500 participants to validate its long-term efficacy in reducing heart attacks and strokes.

• Experts emphasize that if enlicitide is priced affordably, it could vastly improve accessibility for those at risk of cardiovascular diseases and potentially democratize cholesterol control.

• AstraZeneca is also developing a similar PCSK9 pill, indicating a growing interest in oral treatments for managing cholesterol levels.