†Safety and Efficacy of Bempedoic Acid in Patients with Renal Impairment

Catapano, Alberico L.; Helms, Bethany; Lei, Lei; Louie, Michael J.; Bakris, George L.; Tóth, Peter P.

doi:10.1016/j.jacl.2022.05.038

Cited by 4 publications

(2 citation statements)

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“…In a pooled analysis of four phase III studies with a total 3619 patients, including stage 1 (22%), stage 2 (63%), and stage 3a + b (15%) renal function at baseline, LDL-C lowering of BA was similar across renal function subgroups, with significant reductions of 20.8%, 18.8%, and 21.1% at week 12 from baseline in each subgroup, respectively, along with significant apoB reduction. The overall pattern of adverse events and creatinine levels was generally consistent within each renal function subgroup [36]. In a similar pooled analysis, 78% of patients had hypertension, with almost 19% LDL-C reduction at 12 weeks with BA treatment.…”

Section: Bempedoic Acid In Patients With Ckd and Hypertensionmentioning

confidence: 55%

Bempedoic Acid: An Emerging Therapy for Uncontrolled Low-Density Lipoprotein (LDL) Cholesterol

Pradhan

Bhandari

Vishwakarma

et al. 2023

JCDD

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Atherosclerotic cardiovascular disease (ASCVD) is a silent epidemic, which is progressing relentlessly across the globe. Developing countries such as India have a high prevalence of dyslipidemia and consequently a huge burden of coronary artery disease (CAD) and ASCVD. Low-density lipoprotein is regarded as the primary culprit in the genesis of ASCVD, and statins are the first line therapy for LDL-C lowering. Statin therapy has unequivocally demonstrated the benefit of lowering LDL-C in patients across the spectrum of CAD and ASCVD. Muscle symptoms and worsening of glycemic homeostasis could be challenges with statin therapy, especially with the use of high doses. A large fraction of patients are also unable to achieve their LDL goals with statins alone in clinical practice. Moreover, LDL-C goals have become aggressive over years, necessitating a combination of lipid lowering therapies. PCSK-9 inhibitors and Inclisiran have emerged as robust and safe lipid-lowering agents, but parenteral administration and high cost precludes their widespread use. Bempedoic acid is a novel lipid-lowering agent working upstream of statins by inhibiting the enzyme ATP citrate lyase (ACL). The drug produces an average LDL lowering of 22–28% in statin-naïve patients and 17–18% when given to preexisting statin users. Because skeletal muscles lack the ACL enzyme, there is minimal risk of muscle-related symptoms. In combination with ezetimibe, the drug synergistically reduced LDL-C by 39%. Moreover, the drug has no adverse effect on glycemic parameters and lowers hsCRP (inflammation) like statin. The series of four randomized CLEAR trials, involving >4000 patients, have shown consistent LDL lowering across the spectrum of ASCVD patients with or without background therapy. The large and only cardiovascular outcome trial of the drug (CLEAR Outcomes) has recently demonstrated a 13% reduction of MACE at 40 months. Rise in levels of uric acid (four times) and acute gout (three times) are more common compared to placebo with the drug, owing to competitive renal transportation by OAT 2. In a nutshell, Bempedoic acid represents a value addition to the inventory of dyslipidemia management.

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Section: Bempedoic Acid In Patients With Ckd and Hypertensionmentioning

confidence: 55%

Bempedoic Acid: An Emerging Therapy for Uncontrolled Low-Density Lipoprotein (LDL) Cholesterol

Pradhan

Bhandari

Vishwakarma

et al. 2023

JCDD

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“…All patients who suffered from those injuries were, at the same time, treated with statins. No tendon injuries were recorded in patients treated with bempedoic acid who were not treated with statins [34,49,50].…”

Section: Adverse Effectsmentioning

confidence: 99%

Bempedoic acid: new evidence and recommendations on use

Paponja,

Pećin,

Reiner

et al. 2023

Current Opinion in Lipidology

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Purposes of review Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity worldwide. Recognizing the importance of dyslipidemia treatment in the prevention of cardiovascular events has become a part of standard clinical practice. Desired values of LDL cholesterol (LDL-C) have become lower and lower in the last few decades, as evidenced by the most recent guidelines. Therefore, efforts to lower LDL cholesterol concentrations with conventional therapies and combinations of lipid-lowering therapy may not be successful in a high proportion of patients. Recent findings Bempedoic acid is a novel agent, first in-class ATP Citrate Lyase (ACL) inhibitor, which targets biosynthesis of the cholesterol in the liver. Considering the results of phase 3 studies, it has been approved for sole use for dyslipidemia treatment for patients who are statin-intolerant or in combination with statin-ezetimibe for those suffering from familial hypercholesterolemia or ASCVD and unable to reach targeted LDL-C values. Summary Bempedoic acid has proven beneficial for further reduction of LDL cholesterol for targeted groups of patients. It is not only efficient but also a well tolerated, affordable, and available agent whose place in lipid-lowering management is yet to be fully understood with new data collected from ongoing clinical research. In this review we suggest the place of bempedoic acid in lipid-lowering management.

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Bempedoic acid in renal insufficiency

Grützmacher

2023

Nephrologie

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†Safety and Efficacy of Bempedoic Acid in Patients with Renal Impairment

Cited by 4 publications

References 0 publications

Bempedoic Acid: An Emerging Therapy for Uncontrolled Low-Density Lipoprotein (LDL) Cholesterol

Bempedoic Acid: An Emerging Therapy for Uncontrolled Low-Density Lipoprotein (LDL) Cholesterol

Bempedoic acid: new evidence and recommendations on use

Bempedoic acid in renal insufficiency

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