MD NewslineAssessment of Cardiovascular Risk Reduction with Bempedoic Acid

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Bempedoic acid, a novel lipid-lowering therapy, demonstrates cardiovascular risk reduction comparable to statins in patients intolerant to statin therapy. The CLEAR Outcomes trial, involving 13,970 patients, evaluated bempedoic acid’s efficacy in both primary and secondary prevention settings. This study provides insights into the potential of bempedoic acid as an alternative treatment for patients unable to tolerate statins, addressing an important clinical need in cardiovascular risk management.

Key Points:

• Bempedoic acid reduced LDL-C by 21% compared to placebo and decreased major adverse cardiovascular events risk by 13%.
• In the overall cohort, bempedoic acid lowered the risk of major vascular events (HR: 0.85, 95% CI: 0.77–0.94) and major coronary events (HR: 0.81, 95% CI: 0.70–0.93).
• When normalized per 1 mmol/L LDL-C reduction, bempedoic acid showed similar efficacy to statins for major vascular events (HR: 0.75 vs 0.78).
• In the primary prevention cohort, bempedoic acid demonstrated a stronger effect on major vascular events (HR: 0.70, 95% CI: 0.53–0.91) compared to the overall cohort.
• The secondary prevention cohort showed a modest but significant reduction in major vascular events with bempedoic acid (HR: 0.88, 95% CI: 0.79–0.98).
• Bempedoic acid achieved mean LDL-C reductions of 22.4 mg/dL, 23.0 mg/dL, and 22.1 mg/dL in the overall, primary prevention, and secondary prevention cohorts, respectively.

HCN Medical Memo
Bempedoic acid offers a promising alternative for statin-intolerant patients, demonstrating comparable cardiovascular risk reduction to statins when adjusted for LDL-C lowering. Its efficacy in both primary and secondary prevention cohorts suggests potential broad applicability in clinical practice.

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