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September 10, 2026Expert Opinion on Pharmacotherapy

Evaluating enlicitide decanoate: first oral PCSK9 inhibitor for the treatment of adults with hypercholesterolemia

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Authors

CBChristie M. BallantyneAPAngela PirilloACAlberico L. Catapano

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Overview

Clinical review evaluates enlicitide decanoate for lipid lowering in hypercholesterolemia, suggesting oral PCSK9 inhibition may improve treatment adherence over injectable options.

Key Points

  • To review the pharmacology, efficacy, safety, and clinical positioning of enlicitide decanoate, the first oral PCSK9 inhibitor for hypercholesterolemia.
  • Synthesized pharmacological profiles and trial evidence from the phase 2 and phase 3 CORALreef clinical trial program.
  • Evaluated outcomes across patient populations with hypercholesterolemia, heterozygous familial hypercholesterolemia, and established or high risk for atherosclerotic cardiovascular disease.
  • Compared enlicitide data against existing lipid-lowering therapies, including statins, ezetimibe, and approved injectable PCSK9 inhibitors.
  • Enlicitide decanoate demonstrated effective reduction of low-density lipoprotein cholesterol across phase 2 and phase 3 clinical trials.
  • Oral administration provides an alternative to subcutaneous injections, potentially improving patient accessibility and long-term treatment adherence.
  • Definitive adoption will depend on upcoming cardiovascular outcomes data, long-term safety profiles, and cost-effectiveness relative to established injectable agents.

Cite This Study

Ballantyne et al. (2026) studied this question.

synapsesocial.com/papers/6aa27b4758559d80afc745d9https://doi.org/10.1080/14656566.2026.2732054
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