Table 6. Summary of the average impact of anti-lipidemic drugs on plasma Lp(a) levels.

LDLR: Low-Density Lipoprotein Receptor; apo(a): Apolipoprotein (a); PCSK-9: Proprotein Convertase Subtilin/Kexin type 9; CoQ10: Coenzyme Q10; Lp(a): Lipoprotein (a)

Treatment	% reduction in Lp(a)	Mechanism of action	References
Statin	-5% to +20%	HMG-CoA inhibition and increased expression of low-density lipoprotein receptor (LDLR)	[20,23,26-30,44]
Ezetimibe	0 to -10%	Decreased synthesis of Lp(a) and increased uptake through LDLR	[21,22,31]
Fibrates	0 to -20%	Inhibition of apolipoprotein (a) (apo(a)) transcription	[29]
PCSK-9 Inhibitors	-25%	Increased removal by LDLR	[32-34]
Niacin	-20%	Decreased production of apo(a)	[17,35,36,45]
CoQ10	0-15%	Suppression of oxidative stress and increased production of HDL	[24,25]
Lp(a) Apheresis	60% (per procedure); 30% (long term)	Physical removal of Lp(a) particles	[18,40,41]