Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis

Abstract

Background: Bempedoic acid is an oral, once-daily, first-in-class drug being developed for the treatment of hyperlipidemia. However, evidence of bempedoic acid use for the prevention of cardiovascular events and diabetes is lacking. Thus, we aim to evaluate the benefit and safety of bempedoic acid use for the prevention of cardiovascular events and diabetes. Methods: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials with no language restriction from inception until March 3, 2020. Pairs of reviewers independently identified randomized controlled trials comparing the use of bempedoic acid with placebo or no treatment for primary prevention of cardiovascular events in statin-intolerant patients with hypercholesterolemia. The primary outcomes were major adverse cardiac events, and percent change in LDL-C. Results: We identified 11 trials including a total of 4391 participants. Bempedoic acid use was associated with a reduction in composite cardiovascular outcome (RR 0.75, 95% CI 0.56-0.99; I 2 = 0%). Bempedoic acid reduced LDL-C levels (MD − 22.91, 95% CI − 27.35 to − 18.47; I 2 = 99%), and similarly reduced CRP levels (MD-24.70, 95% CI − 32.10 to − 17.30; I 2 = 53%). Bempedoic acid was associated with a reduction in rates of new-onset or worsening diabetes (RR 0.65, 95% CI 0.44-0.96; I 2 = 23%). Conclusions: Bempedoic acid in patients with hypercholesterolemia was associated with a lower risk of cardiovascular events and diabetes.

Clinical efficacy and safety outcomes of bempedoic acid for LDL-C lowering therapy in patients at high cardiovascular risk: a systematic review and meta-analysis

“…It has been Several pooled analyses of trials investigating effects of BA have been performed at the same time by other groups. [26][27][28][29][30] The majority of those focused on BAs capacities in lipid-lowering with comparable results to the current analysis: Allocation to BA as compared with placebo led to highly significant reductions in major atherogenic lipid fractions of LDL-C, non-HDL-C and apoB. [26][27][28][29] In contrast, primary interest of the current meta-analysis was to assess evidence on BAs efficacy in improving relevant clinical outcomes, which is the fundamental objective of pharmacological lipid-lowering.…”

“…[26][27][28][29] In contrast, primary interest of the current meta-analysis was to assess evidence on BAs efficacy in improving relevant clinical outcomes, which is the fundamental objective of pharmacological lipid-lowering. The current work is, along with another recent publication, 30 the first to provide information on this.…”

Bempedoic Acid: The New Kid on the Block for the Treatment of Dyslipidemia and LDL Cholesterol: A Narrative Review

“…A recent meta-analysis combined the outcome of new-onset or worsening diabetes in these four trials which reported 3.7% of individuals taking bempodic acid compared to 5.7% of individuals on placebo [ 34 ]. Bempodeic acid was associated with a risk reduction of 0.65 (95% CI 0.44–0.96; I 2 = 23%) [ 34 ].…”

“…For instance, the use of fibrates as lipid-lowering therapyhas demostrated no significant cardiovascular benefit [ 43 ]. Nonetheless, other drugs such as bempedoic acid and ezetimibe have shown favourable cardioprotective outcomes [ 34 , 43 ]. Given the undisputed causal relationship between LDL-C and ASCVD [ 8 ] with no known level below which further LDL-C lowering ceases to be beneficial [ 44 ], the significant LDL-C reduction with bempedoic acid provides clear hope and the expectation that these data will be translated into a reduction in ASCVD events and subsequent mortality.…”

ETC-1002 Attenuates Porphyromonas Gingivalis Lipopolysaccharide-Induced Inflammation in RAW264.7 Cells via the AMPK/NF-κB Pathway and Exerts Ameliorative Effects in Experimental Periodontitis in Mice

“…ETC-1002 (8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid), previously known as ESP55016 or bempedoic acid, is a novel drug under development for the treatment of dyslipidemia. ETC-1002 has been shown to improve lipid pro les and signi cantly attenuate levels of glucose via the activation of AMPK in multiple animal models [21,22]. Moreover, ETC-1002 was found to regulate immune responses and adipose tissue in ammation via the LKB1-dependent activation of AMPK in macrophages [23].…”