bempedoic acid (Nexletol)
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Indications
- hypertension
- dyslipidemia (hyperlipidemia, hypercholesterolemia)
- may lower LDL cholesterol when added to statin[2][3]
- treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease[4]
- high-risk primary prevention patients[7]
- used in combination with ezetimibe 10 mg
- type 2 diabetes
Dosage
Adverse effects
- slight increase in tendon rupture
- hyperuricemia
- benign prostatic hyperplasia
- atrial fibrillation[5]
- does not increase risk of new-onset diabetes or worsening or HbA1c[8]
Mechanism of action
- inhibits ATP citrate lyase enzyme, involved in cholesterol metabolism upstream to HMG-CoA reductase, the target of statins[2]
- lowers LDL cholesterol by suppressing cholesterol synthesis & upregulating LDL receptors
- decreases LDL cholesterol by 15% over statin alone & by 38% when used in combination with ezetimibe[5]
More general terms
References
- ↑ PubChem: 10472693
- ↑ 2.0 2.1 2.2 Ray KK, Bays HE, Catapano AL et al Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol. N Engl J Med 2019; 380:1022-1032 https://www.nejm.org/doi/full/10.1056/NEJMoa1803917
- ↑ 3.0 3.1 Goldberg AC et al Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial. JAMA. 2019;322(18):1780-1788 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31714986 https://jamanetwork.com/journals/jama/fullarticle/2754792
- ↑ 4.0 4.1 Wendling P Patrice Wendling. New Lipid-Lowering Drug Earns FDA Approval. Medscape - Feb 21, 2020. https://www.medscape.com/viewarticle/925580
- ↑ 5.0 5.1 5.2 Lloyd-Jones DM, Morris PB, Ballantyne CM et al 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2022 Oct, 80 (14) 1366-1418 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36031461 https://www.jacc.org/doi/10.1016/j.jacc.2022.07.006
- ↑ Nissen SE et al Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients. N Engl J Med. 2023. March 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36876740 https://www.nejm.org/doi/10.1056/NEJMoa2215024
- ↑ 7.0 7.1 Nissen SE, Menon V, Nicholls SJ et al Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin- Intolerant Patients. JAMA. Published online June 24, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37354546 https://jamanetwork.com/journals/jama/fullarticle/2806646
- ↑ 8.0 8.1 8.2 Ray KK, Nicholls SJ, Li N, et al. Efficacy and safety of bempedoic acid among patients with and without diabetes: prespecified analysis of the CLEAR Outcomes randomised trial. Lancet Diabetes Endocrinol. 2024 Jan;12(1):19-28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38061370 Free article https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00316-9/fulltext