Bempedoic acid – recommended by guidelines, confirmed in practice

Czech version

Authors: Martin Šatný
Authors‘ workplace: Centrum preventivní kardiologie, III. interní klinika – endokrinologie a metabolizmu 1. LF UK a VFN v Praze
Published in: AtheroRev 2025; 10(3): 174-177
Category: Reviews

Overview

Bempedoic acid (BA) represents another innovation in the treatment of dyslipidemia (DLP), which, by inhibiting ATP citrate lyase, blocks endogenous cholesterol biosynthesis in a similar way to statins (only a few levels higher). Since it is administered as a prodrug, it is activated only in hepatocytes and is therefore not associated with the typical muscle adverse effects that may accompany statin therapy. While BA monotherapy leads to an approximately 20% LDL-C reduction, a reduction of up to 40 % has been documented when administered concomitantly with ezetimibe. Clinical data supporting the use of BA in clinical practice are based primarily on the results of the CLEAR Outcomes study, which clearly documented not only a sustained reduction in LDL-C and hs-CRP, but also in serious CV events (MACE). According to current European guidelines, BA now occupies a firm place in the therapeutic algorithm for the treatment of DLP, especially in patients with high/very high CV risk and statin intolerance, or as an additive treatment to other combination regimens based on statin therapy.

Keywords:

bempedoic acid – dyslipidemia – statin intolerance – cardiovascular risk – ezetimibe – LDL cholesterol

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