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Comprehensive review of statin-intolerance and the practical application of Bempedoic Acid.
- Source :
-
Journal of cardiology [J Cardiol] 2024 Jul; Vol. 84 (1), pp. 22-29. Date of Electronic Publication: 2024 Mar 22. - Publication Year :
- 2024
-
Abstract
- Statin-intolerance (SI) has prevalence between 8.0 % and 10 %, and muscular complaints are the most common reason for discontinuation. Bempedoic acid (BA), an ATP citrate lyase inhibitor, decreases hepatic generation of cholesterol, upregulates low-density lipoprotein (LDL) receptor expression in the liver, and eventually clears circulating LDL-cholesterol from the blood. Multiple randomized clinical trials studying BA demonstrate a reduction in LDL levels by 17-28 % in SI. The CLEAR OUTCOME trial established significant cardiovascular benefits with BA. A dose of 180 mg/day of BA showed promising results. BA alone or in combination with ezetimibe is US Food and Drug Administration-approved for use in adults with heterozygous familial hypercholesterolemia and/or established atherosclerotic cardiovascular disease. BA reduced HbA1c by 0.12 % (p < 0.0001) in patients with diabetes. Adverse events of BA include myalgia (4.7 %), anemia (3.4 %), and increased aminotransferases (0.3 %). BA can cause up to four times higher risk of gout in those with a previous gout diagnosis or high serum uric acid levels. Reports of increased blood urea nitrogen and serum creatinine were noted. Current evidence does not demonstrate a reduction in deaths from cardiovascular causes. More studies that include a diverse population and patients with both high and low LDL levels should be conducted. We recommend that providers consider BA as an adjunct to statin therapy in patients with a maximally tolerated dosage to specifically target LDL levels.<br />Competing Interests: Declaration of competing interest Authors confirm that there is no conflict of interest.<br /> (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Humans
Cholesterol, LDL blood
Ezetimibe therapeutic use
Randomized Controlled Trials as Topic
Anticholesteremic Agents adverse effects
Anticholesteremic Agents therapeutic use
Hypercholesterolemia drug therapy
Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Dicarboxylic Acids therapeutic use
Dicarboxylic Acids adverse effects
Fatty Acids
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4738
- Volume :
- 84
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38521120
- Full Text :
- https://doi.org/10.1016/j.jjcc.2024.03.006