Bempedoic Acid: A New Tool for LDL-Cholesterol Control in Patients with Coronary Artery Disease

Area of Science:

• Cardiology
• Pharmacology
• Biochemistry

Background:

• Many patients with high atherosclerotic cardiovascular disease (ASCVD) risk do not achieve target LDL-cholesterol levels.
• Challenges include drug intolerance, poor adherence, and limitations of current stepwise lipid-lowering strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of bempedoic acid as an add-on therapy for LDL-cholesterol reduction in high-risk patients.

Main Methods:

• Bempedoic acid inhibits adenosine triphosphate-citrate lyase, an enzyme in cholesterol synthesis.
• Clinical trials assessed bempedoic acid alone or in combination with statins and/or ezetimibe.
• Activation is liver-specific, minimizing skeletal muscle side effects.

Main Results:

• Bempedoic acid significantly reduced LDL-cholesterol and high-sensitivity C-reactive protein in clinical trials.
• The drug was well-tolerated, with no significant increase in muscle-related symptoms.
• Effective in patients not reaching LDL-cholesterol goals despite maximally tolerated lipid-lowering therapy.

Conclusions:

• Bempedoic acid is a valuable oral agent for further reducing LDL-cholesterol in high-risk ASCVD patients.
• It offers an effective and well-tolerated treatment option for patients with suboptimal lipid management.
• Addresses unmet needs in managing hypercholesterolemia and reducing cardiovascular risk.