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There’s a small biotech company with big plans to play spoiler in a fight between Amgen and Regeneron Pharmaceuticals, and its cholesterol-lowering pill met its mark in the first of five studies that will determine its fate.

Esperion Therapeutics said Wednesday that its once-a-day pill, combined with the now-generic Zetia, lowered bad cholesterol by 28 percent more than the old drug alone, good enough to meet the trial’s primary goal. The study, involving 269 patients, is the smallest and shortest of the five Esperion expects to report this year. The largest, in which 3,000 patients will get either Esperion’s drug or placebo over the course of at least a year, is scheduled to read out in May.


The goal for Esperion is to drive a wedge in the current market for lipid-lowering therapies. As it stands, the vast majority of at-risk patients get statins, which have long since gone generic and are available for pennies a day for those with insurance. If bad, or LDL, cholesterol stays high, doctors prescribe Zetia. And in extreme cases, they reach for injected treatments from Regeneron and Amgen, which block a protein called PCSK9 and carry list prices of about $14,000.

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