Author ORCID Identifier
https://orcid.org/0009-0007-2261-6809
Abstract
Introduction:
Bempedoic acid (BA) is an inhibitor of ATP-citrate lyase (ACL) and is used in the treatment of hyperlipidemia by inhibiting cholesterol synthesis. Randomized clinical trials (RCTs) have shown the efficacy of BA in lowering LDL-C levels and it is currently approved as a treatment option for patients with hyperlipidemia to achieve target LDL-C levels. We conducted a systematic review to further elucidate the efficacy and safety profile of BA in patients with hyperlipidemia.
Methods:
We searched the electronic database Medline, Embase, and Cochrane Library for RCTs between 2013 and 2023. We used keywords (“Bempedoic Acid”) AND (“Hypercholesterolemia”) AND (“Lipid Lowering”) AND (Randomized Controlled Trials”) AND (“Humans”). Pairs of reviewers also manually searched for RCTs to identify studies comparing the efficacy and safety profile of BA either alone or in combination with other lipid-lowering therapies.
Results:
We identified 11 RCTs in our systematic review, and it showed that the addition of BA either alone or in addition to other lipid-lowering therapies (statins and ezetimibe) resulted in the lowering of LDL-C levels. In addition, BA also led to a reduction in total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (ApoB), and high sensitivity C reactive protein (hs-CRP) levels. For the safety profile of BA, results from the studies show that there is no difference in the incidence of adverse events between the two treatment arms. However, a few studies found that the use of BA was associated with a higher incidence of gout as compared to standard lipid-lowering therapies.
Conclusion:
The use of BA in patients with hyperlipidemia leads to a decrease in the level of LDL-C both alone and in addition to other lipid-lowering therapies like statins and ezetimibe. The addition of BA also led to a reduction in TC, non-HDL-C, ApoB, and hs-CRP levels which resulted in reduction in cardiovascular events. The safety data shows that BA is largely safe to use and the adverse events were similar in both groups, however, the rate of gout was higher in patients receiving BA. Larger clinical trials with longer follow-up duration are needed to adequately assess its effect on cardiovascular mortality and the safety profile of BA.
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Recommended Citation
Sharif MH, Orakzai AA, Khaleeque M, Raza S, Khan O, Jan MH, Ahmed A, Arsalan M. Efficacy and Safety of Bempedoic Acid as a Treatment Option for Hyperlipidemia: A Systematic Review. Advances in Clinical Medical Research and Healthcare Delivery. 2024; 4(2). doi: 10.53785/2769-2779.1198.