New Merck Pill Reduces LDL Cholesterol by 60% Without Injections

A new oral medication developed by Merck significantly reduces levels of harmful LDL cholesterol, potentially transforming the treatment landscape for millions at risk of heart attacks and strokes. The drug, known as enlicitide, has demonstrated the ability to lower LDL cholesterol by up to 60%, comparable to existing injectable treatments. This breakthrough offers an alternative that eliminates the need for regular injections.

The mechanism behind enlicitide involves blocking a liver protein called PCSK9. This protein typically hinders the body’s ability to clear cholesterol from the bloodstream. Dr. Daniel Soffer, a cardiologist at the University of Pennsylvania, emphasized the importance of lower cholesterol levels, stating, “Lower is better for sure.”

Trial Results and Implications

The findings stem from a comprehensive 24-week trial that included 2,912 adults with a history of heart attacks, strokes, or other significant cardiovascular events. Participants who received enlicitide experienced a marked reduction in LDL cholesterol compared to those given a placebo, with no significant differences in side effects reported between the two groups.

Merck’s innovative approach could present a more convenient and cost-effective option compared to current PCSK9 injections, such as Repatha, produced by Amgen, and Praluent, developed by Regeneron and Sanofi. Dr. Dean Li, president of Merck Research Laboratories, expressed the company’s ambition to keep the treatment affordable and accessible, likening it to the routine use of aspirin. “The dream is to democratize PCSK9,” Li noted, highlighting the potential impact of enlicitide on global health.

Scientific Challenges and Future Studies

Developing an oral treatment to inhibit PCSK9 has long been viewed as a formidable challenge due to the protein’s complex structure, which makes targeting it with small molecules difficult. Merck’s research team dedicated a decade to creating a new type of substance—a circular peptide—approximately one-hundredth the size of an antibody. This innovation may also pave the way for future drugs that can replace injectable medications.

To further validate the efficacy of enlicitide, Merck is conducting a larger study involving over 14,500 participants. This research aims to determine whether the significant reductions in cholesterol levels translate into fewer heart attacks, strokes, and deaths. The company anticipates submitting an application for approval to the U.S. Food and Drug Administration (FDA) in early 2026, with hopes of launching the drug in 2027.

Dr. Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston, has welcomed these developments. If the ongoing trials support the initial findings, he remarked, this could indeed “be a game changer” in the treatment of high cholesterol.

For further information on PCSK9 inhibitors and their role in cardiovascular health, resources are available through reputable medical institutions such as the Cleveland Clinic.