Bempedoic acid lowers LDL-C without worsening blood sugar levels

There is interest in how lipid-lowering drugs might affect glycemia because "meta-analyses have shown about a 10% increased risk of new-onset diabetes in statin users. Lawrence A. Leiter, University of Toronto, Canada, and colleagues assessed the efficacy and safety of BA, a first-in-class ATP-citrate lyase inhibitor, by baseline glycemic status including diabetes, prediabetes, or blood sugar status in patients with hypercholesterolemia.

Four phase 3 trials randomized 3623 patients on stable lipid-lowering therapy to receive BA 180 mg or placebo (PBO) once daily for 12 to 52 weeks. Studies were grouped into 2 pools by enrollment criteria (52-weeks in patients with atherosclerotic cardiovascular disease and/or heterozygous familial hypercholesterolemia vs. 12- or 24- weeks in patients with statin intolerance).

The primary efficacy endpoint was percent change from baseline to week 12 in LDL-C. 

 "Bempedoic acid significantly lowered LDL-C and had a safety profile comparable to PBO, regardless of baseline glycemic status," concluded the authors. 

The study, "Efficacy and Safety of Bempedoic Acid in Patients with Diabetes, Prediabetes, and Normoglycemia: Analysis of Pooled Patient-Level Data from Four Phase 3 Clinical Trials," was presented at the American Diabetes Association (ADA) 80th Scientific Sessions.