Page 7 - Reflections_dyslipidaemia_newsletter4_2023

REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #4 2023

This post-hoc analysis of the RACING study suggests that
moderate-intensity statin with ezetimibe combination therapy LISTEN TO A JCC PODCAST Dyslipidaemia
shows similar cardiovascular benefits to those of high- PRESENTED BY EDITOR-IN-CHIEF
intensity statin monotherapy with lower intolerance-related DR. VALENTIN FUSTER ON THE
drug discontinuation or dose reduction in elderly patients with ARTICLE (11:16 MIN).
ASCVD having a higher risk of intolerance, non-adherence, and
discontinuation with high-intensity statin therapy.
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FOR THE LINK TO FULL ARTICLE

Bempedoic acid and cardiovascular outcomes in statin-intolerant patients.
Nissen SE, et al. N Engl J Med. 2023;388(15):1353-1364.

Bempedoic acid is an ATP citrate lyase inhibitor that reduces LDL-C levels without the elevated risk of musculoskeletal adverse
effects associated with statins.

The Cholesterol Lowering via Bempedoic Acid, an ACL-
inhibiting Regimen (CLEAR) study is a double-blind,
randomized, placebo-controlled trial evaluating the
efficacy and safety of bempedoic acid for the prevention
of adverse CV events in statin-intolerant patients. The
study included 13,970 patients 18 to 85 years of age
who were unable or unwilling to take statins owing
to unacceptable adverse effects (“statin-intolerant”
patients) and had, or were at high risk for, CVD. Patients
were assigned to receive oral bempedoic acid, 180 mg
daily, or placebo and the primary endpoint was a four-
component composite of MACE, defined as death from
CV causes, non-fatal MI, non-fatal stroke, or coronary
revascularization.

After six months of treatment, the bempedoic acid
groups had a mean percent reduction of LDL-C of
21.7%, compared to the placebo group that showed
a reduction of 0.6% in LDL-C. This reduction was
maintained over the 60 months. Similarly, there was a
greater reduction in high-sensitivity CRP levels at Month
6, Month 12, and the end of the trial in the bempedoic
acid group (-22.2%, -20.6%, and -19.4%, respectively)
compared to the placebo group (2.4%, 0.0%, and -1.6%,
respectively, for these time points).

After a median follow-up of 40.6 months, the incidence
of four-component MACE was significantly lower in the
bempedoic acid group (11.7%) compared to the placebo
group (13.3%) (HR, 0.87; 95% CI, 0.79–0.96; p=0.004).

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