Cardiometabolic diseases can have multiple drivers. That's especially true for broadly-defined ailments like cardiovascular disease.

The RNA interference (RNAi) drug candidate olpasiran was designed by Arrowhead Pharmaceuticals to reduce apolipoprotein(a), which is a major component of lipoprotein(a) (Lp(a)). Increased levels of LP(a) have been linked to cardiovascular disease regardless of an individual's cholesterol or LDL-cholesterol levels.

Now, Amgen is conducting a massive 6,000-patient study to see if olpasiran has blockbuster potential. A successful outcome would help diversify Amgen's revenue base, among the most stagnant among pharma titans, and cement its position in the suddenly-hot field of cardiometabolic diseases.

A successful study would also be a boon for Arrowhead Pharmaceuticals. In December 2016, the RNAi leader granted Amgen a global license to olpasiran (then ARC-LPA) for $56.5 million upfront. In November 2022, the precommercial drug developer sold its royalty interest in the asset to Royalty Pharma for $250 million upfront. However, Arrowhead has retained rights to up to $350 million in future regulatory, development, and commercial milestone payments as of October 2024.