Summary

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• Bempedoic acid (Nexletol) is used to reduce the risk of myocardial infarction and coronary revascularization in adults unable to take recommended statin therapy, including those not using a statin with established cardiovascular disease or at high risk for a cardiovascular event. It is also employed as an adjunct to diet, in combination with other low-density lipoprotein cholesterol-lowering therapies, or alone when other LDL-C lowering therapy isn't possible.
• Fifteen systemic reviews/meta-analyses focused on Nexletol's efficacy, safety profile, and comparative analysis with other lipid-lowering therapies for managing hypercholesterolemia and preventing cardiovascular disease events.
• Compared to placebos and as an adjunct therapy, Bempedoic acid has shown significant reductions in LDL-C levels. When compared with drugs like statins, ezetimibe, and PCSK9 inhibitors, it presents itself as an effective option, especially among populations intolerant to statins or those not meeting their LDL-C goals solely through the use of statins.
• Several analyses suggest that Bempedoic acid is associated with reduced risks of major adverse cardiovascular events such as non-fatal myocardial infarctions, highlighting its potential role in managing cardiovascular risks among patients unable to achieve lipid goals via other treatments.
• Beyond modifying lipid levels, Bempedoic acid significantly reduces high-sensitivity C-reactive protein (hsCRP), a marker for inflammation, indicating additional benefits contributing towards its protective effects against heart diseases.
• In terms of the safety profile, compared to other lipid-lowering therapies, Bempedoic acid shows favorable results concerning muscle-related adverse events, making it a suitable choice for patients intolerant towards statins. Additionally, there seems to be a lower incidence rate regarding new-onset diabetes, which makes this drug a considerable option for long-term treatment plans.
• However, some studies have reported elevated uric acid levels leading to gout among patients treated with Bempedoic acid. Therefore, careful monitoring is advised for at-risk populations.
• Bempedoic acid has shown effectiveness across various subgroup populations, including those with established atherosclerotic cardiovascular diseases, making it applicable broadly. It's particularly beneficial for statin-intolerant patients and those suffering from mixed hypercholesterolemia who aren't meeting their lipid-lowering goals through conventional therapies.