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100 | Chapter 7 Abstract Purpose of review Lipoprotein (a) (Lp(a)) is an independent risk factor for cardiovascular disease (CVD). The aim of this review is to provide an overview of treatment options for Lp(a) lowering. Recent Findings Recent studies confirmed that lifestyle intervention and statins do not affect Lp(a) levels, whereas Lp(a) is lowered by estrogens, niacin, and lipoprotein apheresis. CETP inhibitors and PCSK9 antibodies, currently studied in phase 3 trials, also lower Lp(a) concentrations by 30-50%. However, all of these compounds have modifying effects on multiple lipoprotein classes. An antisense oligonucleotide directed to apolipoprotein (a) has recently been developed to specifically lower circulating Lp(a) levels. This compound inhibited Lp(a) mRNA up to 90%, and Lp(a) levels up to 82% in human volunteers independent of Lp(a) levels at baseline. Summary Multiple agents, including the next generation RNA based antisense therapeutics have Lp(a) lowering properties . However, it remains to be established whether lowering Lp(a) reduces CVD events with specific Lp(a) lowering therapies. Keywords (3-5) • Lipoprotein (a) • Treatment • Cardiovascular disease • Risk factor