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HRS-5346 + enlicitide is an investigational oral combination therapy being developed by Merck and Jiangsu Hengrui Pharmaceuticals for the treatment of cardiovascular diseases, specifically targeting patients with elevated lipoprotein(a) [Lp(a)] and high cardiovascular risk. The combination consists of HRS-5346 (MK-7262), an oral small molecule inhibitor of Lp(a) particle assembly, and enlicitide (MK-0616, Lipfendra), an oral macrocyclic peptide inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9). HRS-5346 prevents the assembly of apolipoprotein(a) and apolipoprotein B-100 into Lp(a) particles, thereby lowering circulating Lp(a) levels. Enlicitide binds to PCSK9, preventing its interaction with LDL receptors and leading to increased clearance of low-density lipoprotein cholesterol (LDL-C) from the blood. By combining these two oral agents, the therapy aims to provide a comprehensive, all-oral lipid-lowering regimen that simultaneously reduces both Lp(a) and LDL-C, offering a convenient alternative to injectable therapies.
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