Clinical Readouts Poised to Reshape Therapeutic Landscapes in H1 2026

As 2026 begins, the pharmaceutical industry is bracing for a series of high-stakes clinical readouts that have the potential to significantly impact multiple therapeutic areas. From cardiovascular disease to Alzheimer's and obesity, these trials are set to provide crucial data that could shape treatment paradigms and market dynamics for years to come.

Novartis' Pelacarsen: A Pivotal Moment for Cardiovascular Disease

The first half of 2026 will see the much-anticipated readout from Novartis' Phase III Lp(a)HORIZON study of pelacarsen, an antisense medicine designed to lower lipoprotein(a) [Lp(a)], a genetically defined risk factor for cardiovascular disease. Originally expected in 2025, the readout was delayed due to fewer cardiovascular events occurring in the trial than anticipated.

Pelacarsen's performance is being closely watched not just for Novartis but for the entire cardiovascular field. Myles Minter, a biotech equity research analyst at William Blair, described it as the "biggest biotech event of the entire year." The trial's outcome could validate the Lp(a)-lowering approach, potentially opening the door for a market projected to be worth over $8.5 billion by 2033.

With several Big Pharma companies, including Amgen, Eli Lilly, AstraZeneca, and Merck, also targeting this pathway, the results of the Lp(a)HORIZON study will serve as a crucial benchmark for the industry. A positive outcome could spark a race to develop similar therapies, while disappointing results might force a reevaluation of this approach to cardiovascular risk reduction.

Eli Lilly's Remternetug: The Next Chapter in Alzheimer's Treatment

Eli Lilly is poised for a significant first half of 2026, with top-line Phase III data expected from the TRAILRUNNER-ALZ 1 study of remternetug in Alzheimer's disease. This anti-amyloid antibody is positioned as the successor to Lilly's Kisunla, which received FDA approval in 2024.

The TRAILRUNNER-ALZ 1 study, involving more than 1,600 patients with early, symptomatic Alzheimer's, is assessing both subcutaneous and intravenous formulations of remternetug. The primary outcome measure focuses on amyloid plaque clearance, with the subcutaneous format potentially offering advantages in terms of patient preference and reduced risk of amyloid-related imaging abnormalities.

Phase I data presented in 2023 showed promising results, with IV remternetug lowering beta-amyloid plaques after 85 days in most dosing regimens. The outcome of this trial could further solidify Eli Lilly's position in the competitive Alzheimer's market and potentially offer new hope for patients and caregivers.

Emerging Therapies in Obesity and Ophthalmology

The first half of 2026 will also see important developments in other therapeutic areas. Wave Life Sciences is expected to release follow-up data from its Phase I trial of WVE-007, a novel approach to obesity treatment. The therapy, delivered via a single RNAi injection to silence mRNA encoding the INHBE protein, has shown promising early results, including fat loss comparable to GLP-1 agonists and potential increases in lean mass.

In ophthalmology, Ocular Therapeutix is set to report data from the Phase III SOL-1 trial of Axpaxli in wet age-related macular degeneration (wet AMD). If successful, this tyrosine kinase inhibitor, dosed every six months, could represent a significant advance in treatment frequency for wet AMD patients.

As these trials unfold, the pharmaceutical industry stands at the cusp of potentially transformative developments across multiple therapeutic areas. The results of these studies will not only impact the fortunes of individual companies but could also reshape treatment paradigms and patient care in cardiovascular disease, Alzheimer's, obesity, and ophthalmology.