The FDA approval of the autoinjector builds on the original approval basis: the phase 3 LIBerate Clinical Trial Program, described by LIB Therapeutics as a comprehensive global registration effort. The program enrolled more than 2900 patients across cardiovascular disease, high and very high cardiovascular risk without established disease, and heterozygous and homozygous familial hypercholesterolemia (HeFH) populations. Patients received lerodalcibep-liga once monthly for up to 52 weeks in the placebo-controlled registration trials, and more than 2400 patients continued into a 72-week open-label extension.1,2
According to the company, lerodalcibep-liga produced sustained LDL-C reductions of 60% or more in patients with, or at very high or high risk for, cardiovascular disease, and reductions of 59% or more in patients with HeFH. The autoinjector delivers the same dose as the prefilled syringe in a device designed for quick self-administration, and does not require overnight fasting or timing around food or oral medications.1
Lerodalcibep safety profile and updated MACE indication
Safety data cited in the release reflect adverse event rates from the LIBerate program's placebo-controlled trials. In studies of primary hyperlipidemia, including HeFH, injection site reactions occurred in 12% of lerodalcibep-liga-treated patients compared with 5% of placebo patients, and nasopharyngitis occurred in 15% vs 14%, respectively. In trials restricted to patients with HeFH, injection site reactions occurred in 18% of treated patients vs 3% with placebo, alongside nasopharyngitis (13% vs 9%), diarrhea (3% vs 1%), nausea (2% vs 0%), and peripheral edema (2% vs < 1%).1
Injection site reactions were also the most frequent adverse reaction leading to discontinuation, occurring in 1% of lerodalcibep-liga-treated patients vs none of the placebo group. LIB Therapeutics reports no serious treatment-related adverse events in the long-term, 72-week open-label extension study. The updated indication statement now explicitly references MACE risk reduction achieved through LDL-C lowering with statins or with monoclonal antibody PCSK9 inhibitors used as add-on therapy to statins, aligning lerodalcibep-liga's label with the broader PCSK9 inhibitor class.1
LIB Therapeutics has also submitted a marketing authorization application to the European Medicines Agency, with anticipated approval in the second half of 2026, and a biologics license application in Greater China, with potential approval in 2027. The company plans to pursue additional regulatory submissions in other markets. LIB expects the autoinjector to be available in the United States by January 2027, at the same $199 monthly direct-to-patient cash price as the prefilled syringe.1
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