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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
PubMed

Insights

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.

Keywords:
bempedoic acidcardiovascular riskdyslipidaemialipid-lowering therapystatin intolerance

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