Examining the use of bempedoic acid in preventing cardiovascular events in patients who are statin- intolerant

In a subgroup of high-risk primary prevention patients, bempedoic acid treatment was associated with reduced major cardiovascular events, according to a recent study published in JAMA Network. The effects of bempedoic acid on cardiovascular outcomes in statin-intolerant patients without a prior cardiovascular event (primary prevention) have not been fully described.

The study by Steven E. Nissen et al, aimed to determine the effects of bempedoic acid on cardiovascular outcomes in primary prevention patients.This masked, randomized clinical trial enrolled 13 970 statin-intolerant patients including 4206 primary prevention patients.

Mean participant age was 68 years, 59% were female, and 66% had diabetes. Participants were randomized to oral bempedoic acid, 180 mg daily or matching placebo.

Main Outcome Measures The primary efficacy measure was the time from randomization to the first occurrence of any component of a composite of cardiovascular death, nonfatal myocardial infarction (MI), nonfatal stroke, or coronary revascularization.

From a mean baseline of 142.5 mg/dL, compared with placebo, bempedoic acid reduced low-density lipoprotein cholesterol levels by 21.3%) and high-sensitivity C-reactive protein levels by 21.5%).. Follow-up for a median of 39.9 months was associated with a significant risk reduction for the primary end point and key secondary end points.

Reference: 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. doi:10.1001/jama.2023.9696