FH Treatments

Bempedoic Acid

Bempedoic acid is a non-statin treatment to lower LDL-cholesterol in individuals with familial hypercholesterolemia or established cardiovascular disease who require additional LDL-C lowering even after maximally tolerated statin treatment.

Bempedoic acid lowers the level of cholesterol in the blood by reducing the production of cholesterol in the liver. It inhibits an enzyme in the liver (ATP citrate lyase) that is responsible for making cholesterol.

Bempedoic acid also increases LDL receptors which help remove LDL cholesterol from the blood.

Cholesterol Lowering Medication - Bempedoic Acid

Effectiveness of Bempedoic Acid

Bempedoic Acid Diagram by www.esperion.comA Bempedoic acid tablet (brand name NEXLETOL) is an oral, once-daily non-statin LDL-Cholesterol (LDL-C) lowering medicine. In a 3,000 person study, bempedoic acid was shown to reduce LDL-cholesterol by 18 percent when used with moderate or high intensity statins. [1], [2]

This therapy was approved by the Food and Drug Administration (FDA) in 2020 and became available by prescription on March 30, 2020. While it has been shown to be safe and effective, the effect of bempedoic acid on cardiovascular morbidity and mortality has not yet been determined. Further studies are underway.

Who Is Bempedoic Acid Recommended For?

Bempedoic acid may be prescribed for:

  • People with elevated LDL cholesterol despite maximally tolerated lipid lowering medications who have familial hypercholesterolemia
  • People with elevated LDL cholesterol despite maximally tolerated lipid lowering medications who have established atherosclerotic heart disease

Not everyone can take bempedoic acid including women who are trying to conceive, who are pregnant, or nursing. It is important to talk to your doctor if you are taking simvastatin or pravastatin. Your dose of these medicines may need to be lowered while taking bempedoic acid.

Effectiveness of Bempedoic Acid

A combination pill of bempedoic acid and ezetimibe was also recently approved by the Food and Drug Administration and is expected to be available in Summer 2020.

References

[1] Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol- Ray et al. N Engl J Med. 2019;380:1022. https://www.nejm.org/doi/full/10.1056/NEJMoa1803917

[2] Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial- Goldberg et al. JAMA. 2019;322:1780. https://jamanetwork.com/journals/jama/article-abstract/2754792?resultClick=1