The US Food and Drug Administration (FDA) has granted 510(k) clearance to Roche's Tina-quant® Lipoprotein (a) Gen.2 Molarity assay, establishing a new milestone as the first blood test approved for measuring lipoprotein(a) [Lp(a)] in molar units in the United States. The announcement, made on January 29, 2025, represents a significant advancement in cardiovascular risk assessment and lipid disorder evaluation.
Clinical Significance and Testing Methodology
The newly cleared test measures Lp(a) particles per liter in patient bloodstream samples through routine blood draws, providing clinicians with actionable data to assess future atherosclerotic cardiovascular disease (ASCVD) risk. Scientific consensus has established that Lp(a) measurement in nanomoles per liter (nmol/L) is more accurate than traditional mass units (mg/dL), given the variable size and undefined molecular weight of Lp(a) particles.
Genetic Determinants and Population Impact
Dr. Pam Taub, professor in cardiovascular medicine at UC San Diego School of Medicine, emphasizes the genetic nature of Lp(a) levels: "Through no fault of our own, Lp(a) levels are determined at birth by genetics and thought to be unaffected by lifestyle changes, with approximately 20% of individuals living with elevated levels of this particle." The condition particularly affects individuals of African descent and post-menopausal women.
Risk Assessment and Clinical Applications
The test's introduction aligns with the National Lipid Association's (NLA) recommendations for universal Lp(a) testing at least once in a lifetime. Lp(a) has emerged as a crucial ASCVD risk factor, contributing to:
- Arterial plaque propagation
- Clot formation
- Aortic valve calcification
Implementation and Availability
Roche will make the test widely available on their cobas® chemistry analyzer systems across the United States. Brad Moore, president and CEO of Roche Diagnostics North America, stated, "We are proud to support the NLA's recommendation for Lp(a) testing, emphasizing accurate cardiovascular risk assessment with the first FDA-cleared test measuring in nmol/L units in the US."
Future Therapeutic Implications
The timing of this diagnostic advancement is particularly significant, as Roche received FDA Breakthrough Device Designation for their Tina-quant Lp(a) RxDx assay in May 2024. This companion diagnostic tool is designed to identify patients who may benefit from upcoming Lp(a)-lowering therapies, suggesting a coordinated approach to diagnosis and treatment of elevated Lp(a)-related cardiovascular risk.
