Bempedoic acid as treatment for subjects at cardiovascular risk who are statin-intolerant
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Abstract
INTRODUCTION: Atherosclerotic cardiovascular disease is the leading cause of death globally.LDL cholesterol is a key risk factor for cardiovascular disease. The most common group of medicines forlowering LDL cholesterol are the statins, as they reduce the risk of cardiovascularevents. However, some subjects arestatin-intolerant and remain at high risk. AREASCOVERED: CLEAR Outcomes; a phase 3 clinicaltrial of bempedoic acid, an ATP citrate lyase (ACL) inhibitor, in subjects whodo not tolerate statins or are unable to take the recommended dose. It enrolledsubjects with prior cardiovascular events (secondary prevention) and at highrisk (primary prevention). The primary endpoint was a composite of majoradverse cardiovascular events, and this occurred in less subjects in thebempedoic acid than the placebo group. EXPERT OPINION: Bempedoic acid issuitable for use as monotherapy in the prevention of cardiovascular events instatin intolerant subjects, and it has a good safety profile in most subjects.However, the effects of bempedoic acid inlowering LDL cholesterol and cardiovascular events are modest. This suggests that more benefits may ensue ifbempedoic acid was used in combination with other lipid lowering agents tocause larger decreases in LDL cholesterol.
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Expert Opinion on Pharmacotherapy
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This is the peer reviewed version of the following article: Sheila A Doggrell (2023) Bempedoic acid as treatment for subjects at cardiovascular risk who are statin-intolerant, Expert Opinion on Pharmacotherapy, which has been published in final form at https://doi.org/10.1080/14656566.2023.2242259. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
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Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
ATP citrate lyase (ACL) inhibitor
bempedoic acid
cardiovascular outcomes
ezetimibe
statin-intolerant
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Doggrell, SA, Bempedoic acid as treatment for subjects at cardiovascular risk who are statin-intolerant, Expert Opinion on Pharmacotherapy, 2023