Bempedoic acid reduced cardiovascular events in primary prevention patients who could not tolerate statins, according to new research.
Bempedoic acid has advantages, according to medical professionals, but more research is required.
Heart health can be improved through lifestyle therapy, which includes regular exercise and a well-balanced diet.
The majority of cardiovascular outcome trials involving lipid-lowering medications only looked at participants who had previously experienced a cardiovascular event.
So, researchers wanted to see how bempedoic acid affects cardiovascular outcomes in statin-intolerant people who have never had a heart attack or other major cardiovascular event.
Bempedoic acid reduced the risk of cardiovascular events like heart attack or stroke in these patients who were unable to tolerate statins, according to a new study that was published in JAMATrusted Source.
This alternative helped lower levels of “bad cholesterol” The results showed that bempedoic acid reduced levels of low-density lipoprotein cholesterol by about 21%, or 30.2 mg/dL. The randomized clinical trial involved 13,970 patients who were intolerant of statins, including 4,206 patients who had not experienced any cardiovascular events.
Among the participants, 59% were women and 66% had diabetes, with an average age of 68.
The director of Women’s Heart Health at Northwell Lenox Hill Hospital, Dr. Eugenia Gianos, stated, “This is an exciting new therapy in patients who are truly statin intolerant.” In contrast to other trials, this subgroup had a high representation of women, with over half of the study population being female. It also improved cardiovascular outcomes in all patients.
Gianos explained that although primary prevention patients who have not experienced a cardiovascular event probably represent the most exciting patient population for the use of this medication if they are intolerant of statins, it can also be considered an add-on therapy for patients with heart disease who are unable to lower their cholesterol with other treatments.
Is bempedoic acid an effective statin-intolerant patient prevention strategy?
Bempedoic acid has advantages, according to medical professionals, but more research is required.
Nick West, M.D., chief medical officer and divisional vice president of global medical affairs at pharmaceutical company Abbott’s vascular business, stated, “Bempedoic acid significantly reduces both systemic inflammation (measured by high-sensitivity C-reactive protein) and LDL cholesterol, translating into favorable reductions in hard cardiovascular endpoints” from these data and the overall CLEAR study analysis. However, the majority of available evidence in this area favors statin therapy when individuals are able to tolerate it; consequently, trials of various statins at various doses ought to be strongly encouraged prior to resorting to a relatively new therapy with only one high-quality study to support it.
One of the study’s authors, Kausik K. Ray, MD, of Imperial College London, London, United Kingdom, receives consulting fees from Abbott, which manufactures statins.
In addition, it is important to note that this is a secondary analysis of a larger trial and should be regarded as generating hypotheses: West added that before this agent becomes a first-line option for primary prevention in statin-intolerant patients, additional studies involving patients with adverse risk, statin intolerance, and possibly both elevated and “normal” LDL-cholesterol are required.
Recommendations for patients who are intolerant of statins In order to lower LDL cholesterol and lower the risk of cardiovascular problems, statins are likely to continue to be a staple of cholesterol management.
Other cholesterol-lowering and risk-reducing medications, such as fibrates, PCSK-9 inhibitors, and bile acid sequestering agents, have also been shown to improve cardiovascular outcomes.
Patients should also focus on non-pharmacological measures to favorably improve their LDL-cholesterol and overall cardiovascular risk profile, such as maintaining a healthy body mass index, participating in regular exercise, abstaining from smoking, and eating a healthy and low-cholesterol diet, West noted. While the relative risk of cardiovascular events is high in these patients, the absolute risk remains lower.
Gianos stated, “Lifestyle therapy, like the best diet and exercise, should be used across the board because it not only lowers cholesterol but also offers so many other health benefits.”
Be aware of the risks associated with bempedoic acid before attempting a new treatment or medication.
Bempedoic acid’s overall safety profile was excellent. It is important to keep in mind that it may slightly worsen gallstones and raise uric acid, so it should probably be avoided by people who have gout. According to Gianos, “the slight increases in liver and kidney markers are not likely to be clinically meaningful.”
Additionally, West advised that bempedoic acid carries a number of dangers.
According to West, “Bempedoic acid can cause an elevation in uric acid levels leading to attacks of gout, as well as elevation of liver enzymes – sometimes associated with gallstone formation,” although it is not associated with the myalgia or muscle cramps that are frequently reported with statins. Even though these events appear to be rare, use of the drug should be considered on an individual basis, weighing each patient’s risk of these events against any potential cardiovascular benefits.
Takeaway: New research shows that taking bempedoic acid reduced cardiovascular events in primary prevention patients who were unable to tolerate statins.
Experts concur that additional research is required despite these promising findings.
It is recommended to make changes to one’s lifestyle, like eating a healthy diet and exercising regularly, to improve heart health.
