Bempedoic acid

(Nexletol®)

Nexletol®

Drug updated on 3/28/2024

Dosage FormTablet (oral: 180 mg)
Drug ClassAdenosine triphosphate-citrate lyase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.

Summary
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  • Bempedoic acid (Nexletol) is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.
  • A total of 10 systematic reviews/meta-analyses were reviewed, providing insights into the efficacy and safety profile of bempedoic acid in patients requiring lipid-lowering therapy.
  • The combination therapies involving bempedoic acid have shown significant reductions in low-density lipoprotein cholesterol (LDL-C), total cholesterol, non-high-density lipoprotein cholesterol, apolipoprotein B, and hsCRP levels compared to standard treatments alone among high-risk cardiovascular patients including those intolerant to statins.
  • In terms of safety considerations for prescribing decisions, while bempedoic acid has been associated with a lower risk of new-onset diabetes mellitus than controls; it also showed increased risks related to discontinuation due to adverse effects such as elevated serum uric acid level, liver enzymes elevation and creatine kinase increase which necessitates regular monitoring during its use.
  • Despite these side effects observed across studies included in this review; overall evidence suggests that bempedoic acid provides a well-tolerated therapeutic option for lipid lowering especially when combined with other drugs like ezetimibe or statins among hyperlipidemic patients failing on maximum tolerated doses or intolerant individuals respectively.
  • Further long-term trials are recommended by researchers given the relatively small number involved so far along with short-to-middle term duration natured ones currently available, aiming at exploring more about its longer-term safety besides confirming current findings regarding effectiveness against hypercholesterolemia particularly within different patient subgroups.

Product Monograph / Prescribing Information

Document TitleYearSource
Nexletol (bempedoic acid) Prescribing Information.2021Esperion Therapeutics, Inc., Ann Arbor, MI

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of bempedoic acid lipid-lowering therapy: a systematic review and meta-analysis of randomized controlled trials.2023European journal of clinical pharmacology
Network meta‐analysis of randomized trials evaluating the comparative efficacy of lipid‐lowering therapies added to maximally tolerated statins for the reduction of low‐density lipoprotein cholesterol. 2022Journal of the American Heart Association
Bempedoic acid’s use as an adjunct in lowering low-density lipoprotein cholesterol in patients with coronary artery disease: a systematic review.2022Cureus
Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia.2021NICE
Bempedoic acid and inclisiran for patients with heterozygous familial hypercholesterolemia and for secondary prevention of ASCVD: effectiveness and value.2021ICER
Assessment report: Nilemdo.2020EMA
Efficacy and safety of bempedoic acid for the treatment of hypercholesterolemia: a systematic review and meta-analysis.2020PLOS Medicine
Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials.2020Sage Journals
Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis.2020Cardiovascular Diabetology
Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: systematic review and meta‐analysis of randomized controlled trials.2020Journal of the American Heart Association
Efficacy and safety of bempedoic acid alone or combining with other lipid lowering therapies in hypercholesterolemic patients: a meta-analysis of randomized controlled trials.2020BMC Pharmacology and Toxicology
Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials.2020European Journal of Preventive Cardiology
Bempedoic acid and ezetimibe for the treatment of hypercholesterolemia: a systematic review and meta-analysis of randomized phase II/III trials.2020Clinical Drug Investigation

Clinical Practice Guidelines

Document TitleYearSource
VA/DoD clinical practice guideline for the management of dyslipidemia for cardiovascular risk reduction. 2020Department of Veterans Affairs Department of Defense