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Merck’s Oral PCSK9 Pill Matches Injectables in Phase 3, Setting Up 2026 FDA Bid

Merck plans to seek FDA review in early 2026 based on these Phase 3 lipid-lowering results.

Overview

  • Enlicitide cut LDL cholesterol by about 56% at 24 weeks in the CORALreef Lipids Phase 3 trial, with reductions approaching 60% in some analyses and remaining roughly 48% to 52% at one year.
  • A separate Phase 3 study in heterozygous familial hypercholesterolemia showed about a 59% LDL reduction at 24 weeks versus placebo, with effects sustained through 52 weeks.
  • Safety findings were comparable to placebo, including similar rates of serious adverse events (10% vs. 12%) and low discontinuations, and investigators reported improvements in non‑HDL cholesterol, ApoB and Lp(a).
  • The main trial enrolled 2,912 adults across 14 countries, most already on statins and some on ezetimibe, and evaluated once‑daily oral dosing of the investigational PCSK9 inhibitor.
  • An outcomes trial is ongoing to determine whether LDL lowering with enlicitide reduces heart attacks and strokes, and analysts note potential adherence considerations such as fasting requirements around dosing.