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EFFICACY AND SAFETY OF BEMPEDOIC ACID FOR LDL-C REDUCTION IN STATIN-INTOLERANT PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Abstract   Peer reviewed

EFFICACY AND SAFETY OF BEMPEDOIC ACID FOR LDL-C REDUCTION IN STATIN-INTOLERANT PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Muhammad Adil Afzal, Muhammad Abdullah, Noman Khalid, Mubariz Ahmed Hassan, Yezin F. Shamoon, Muhammad Atif M. Noori, Salman M. Muddassir, Rahul Vasudev and Fayez E. Shamoon
Journal of the American College of Cardiology, Vol.85(12 Suppl), pp.673-673
04/01/2025
DOI: 10.1016/S0735-1097(25)01157-X

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Abstract

Background Elevated LDL-C levels pose a significant cardiovascular risk. Bempedoic acid (BA) is a novel cholesterol lowering agent for statin-intolerant patients. This review evaluates BAʼs efficacy and safety in reducing LDL-C levels. Methods A systematic search of major databases was conducted. The included studies were analyzed using the random effects model. Mean differences were calculated for lipid levels, while odds ratios (ORs) were determined for adverse events. Results After the initial search, 461 studies were retrieved, and through title and abstract screening, four randomized controlled trials (RCTs) with a total of 14,637 participants were included in the meta-analysis. BA demonstrated a significant reduction in LDL-C levels compared to placebo, with a mean difference of -23.7 (95% CI -27.63 to -19.76; p<0.00001). Additionally, BA showed significant reductions in total cholesterol levels, apolipoprotein B levels, high-density lipoprotein cholesterol (HDL-C), and non-HDL-C levels. Regarding adverse effects, BA did not significantly increase the odds of severe or muscle-related adverse effects. However, it was associated with increased odds of elevated transaminases, renal impairment, and gout Conclusion BA shows promise in lowering cholesterol in statin-intolerant patients, mainly due to its favorable muscle-related side effect profile. However, larger RCTs focusing on diverse populations must further ascertain BAʼs efficacy and safety.

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