Peter Attia· MD
those drugs are in early you know like anything else the first generation of those antisense oligosaccharide drugs that came around they've perfected them so there's a second generation of them now that they've made even more hepatoselective so they can dose less of it and it goes right into the liver but they're phase one phase 1-2 trials on novartis i believe has now acquired the product that they're going to put it in a major which has just started enrollment of phase 3 trial on let's not but here's the problem peter knows the billions that probably have to be invested when you're developing a drug of that type of magnitude to reduce something you're not going to do it on every tom dick and harry who has a trivial lp little a you want that first trial to work because if it doesn't that's it detroit the drug is dead it'll never be tested in lesser risk people so the only way you can get into this current apo little a synthesis modulator drug is you have to have had an atherosclerotic clinical event a myocardial infarction stroke blah blah blah stents and you have to have an astronomical like upper quintile concentration of lp little a because mendelian trials suggests if you're going to get benefit by lowering april little a or lp little a it has to be a pretty significant drop in it