Related Experiment Video

Updated: Mar 28, 2026

Semi-Targeted Ultra-High-Performance Chromatography Coupled to Mass Spectrometry Analysis of Phenolic Metabolites in Plasma of Elderly Adults
14:39

Semi-Targeted Ultra-High-Performance Chromatography Coupled to Mass Spectrometry Analysis of Phenolic Metabolites in Plasma of Elderly Adults

Published on: April 22, 2022

4.5K

Evaluation of bempedoic acid in elderly patients: real-world evidence from the REALIST study

Saverio Muscoli1, Emanuele Di Marco1, Fiorella Puttini1

  • 1Division of Cardiology, Policlinico Tor Vergata, Rome, Italy.

Frontiers in Aging
|March 27, 2026
PubMed

Insights

Bempedoic acid effectively lowers cholesterol in elderly patients over 81 with high cardiovascular risk. This ATP-citrate lyase inhibitor showed good tolerability and efficacy, offering a new option for those intolerant to statins or PCSK9 inhibitors.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Limited lipid-lowering options exist for elderly patients due to statin intolerance and PCSK9 inhibitor reimbursement restrictions.
  • High cardiovascular (CV) risk in the elderly necessitates effective and safe lipid management strategies.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of bempedoic acid (BA) in patients over 81 years with medium to very high CV risk.
  • To assess the impact of BA on lipid profiles, renal and hepatic function, and adverse events in this specific elderly cohort.

Main Methods:

  • Analysis of 54 patients (mean age >81 years) from a larger cohort (2,564 individuals) receiving BA for 52 weeks.
  • Assessment of lipid profiles (LDL-C, HDL-C, triglycerides, total cholesterol), renal and hepatic function markers.
  • Monitoring of adverse events and treatment discontinuations.

Main Results:

  • Bempedoic acid significantly reduced LDL-C, triglycerides, and total cholesterol.
  • High-Density Lipoprotein Cholesterol (HDL-C) levels remained stable.
  • Renal and hepatic function were unaffected; increased uric acid was the sole notable adverse event, with no treatment discontinuations.

Conclusions:

  • Bempedoic acid is an effective and well-tolerated lipid-lowering agent in very elderly patients at high cardiovascular risk.
  • BA presents a valuable alternative for statin-intolerant patients or those ineligible for PCSK9 inhibitors.
  • Further research is warranted to confirm the long-term cardiovascular benefits of bempedoic acid in this population.

Keywords:
bempedoic acid (BA)cardiovascular risk managementelderly patienthigh cardiovascular riskreal-world data (RWD)statin intolerance

Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
315
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
346
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
802
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
315
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
324
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
340