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Reshaping Dyslipidaemia Treatment with Bempedoic Acid-A Narrative Review
Dominik Strikic1, Zvonimir Begic2, Ivana Radman3
1Division of Clinical Pharmacology, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia.
Biomedicines
|June 26, 2025
Summary
Bempedoic acid effectively lowers LDL-C and reduces cardiovascular events in statin-intolerant patients. Combination therapy with ezetimibe enhances efficacy, but monitoring for side effects like increased uric acid is crucial.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Dyslipidaemia is a primary driver of atherosclerotic cardiovascular disease (ASCVD).
- Statins are standard therapy, but many patients experience intolerance or suboptimal low-density lipoprotein cholesterol (LDL-C) levels.
- Alternative lipid-lowering agents are needed for effective ASCVD risk reduction.
Purpose of the Study:
- To review the pharmacological profile and clinical efficacy of bempedoic acid.
- To evaluate bempedoic acid's role in managing dyslipidaemia, particularly in statin-intolerant patients.
- To synthesize current evidence on bempedoic acid and identify future research directions.
Main Methods:
- Review of recent clinical trials, including the CLEAR Outcomes Study.
- Analysis of bempedoic acid's mechanism of action as an ATP citrate lyase inhibitor.
- Comparative synthesis of efficacy data, including combination therapy with ezetimibe.
Main Results:
- Bempedoic acid demonstrated a significant reduction in LDL-C (approx. 29 mg/dL).
- The CLEAR Outcomes Study showed a 13% reduction in major adverse cardiovascular events (MACEs) in statin-intolerant patients.
- Combination therapy with ezetimibe further improved lipid-lowering effects.
Conclusions:
- Bempedoic acid offers a valuable therapeutic option for lowering LDL-C and reducing cardiovascular risk in statin-intolerant individuals.
- Careful patient selection and monitoring are necessary due to potential adverse effects, such as elevated uric acid and gout.
- Further research is needed to fully elucidate bempedoic acid's long-term benefits and optimal use in diverse patient populations.
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