In a breakthrough that could reshape how millions manage high cholesterol, pharmaceutical major Merck has unveiled a new investigational pill that slashes harmful LDL cholesterol by up to 60% — matching the potency of today’s injectable PCSK9 inhibitors.

The oral drug, named enlicitide, works by blocking the liver protein PCSK9, a key regulator that slows down the body’s ability to clear cholesterol from the bloodstream. Until now, targeting PCSK9 with a pill was considered nearly impossible because of the protein’s complex structure.

But Merck’s researchers spent a decade developing a novel circular peptide, a tiny molecule just one-hundredth the size of an antibody, capable of doing what injections do — but in pill form.

The findings come from a 24-week clinical trial involving 2,912 adults who had previously experienced a heart attack, stroke, or were at high risk for cardiovascular disease. Participants who received enlicitide saw LDL levels fall by as much as 60%, compared with those given a placebo. Importantly, researchers observed no significant difference in side effects between the two groups.

“Lower is better for sure,” said Dr. Daniel Soffer, a cardiologist at the University of Pennsylvania, speaking to The New York Times.

Today’s PCSK9 inhibitors — such as Amgen’s Repatha and Regeneron/Sanofi’s Praluent — are highly effective but expensive and require injections, limiting wider adoption. Enlicitide, if successful, could offer a far simpler option.

Merck Research Laboratories president Dr. Dean Li said the company aims to make the treatment as routine and accessible “as taking aspirin.”

“The dream is to democratize PCSK9,” he said. “This dream has the possibility of coming true.”

Merck is now conducting a bigger trial with over 14,500 participants to determine whether the dramatic cholesterol reductions will translate into fewer heart attacks, strokes, and deaths.

The company plans to seek FDA approval in early 2026 and hopes to bring the pill to market by 2027.

Cardiologist Dr. Christopher Cannon of Brigham and Women’s Hospital praised the early results, calling the development a potential “game changer” if the findings continue to hold.

If successful, enlicitide could mark a major milestone in preventive heart care — offering millions an easier, needle-free way to protect their hearts and reduce cardiovascular risk.