A retrospective cohort of 641 patients at seven German specialist lipid clinics measured LDL cholesterol before and about three months after starting bempedoic acid. Mean LDL cholesterol fell by 17.5% at three months, and the reduction was smallest in those already taking a statin with ezetimibe (6.1%). Suspected adverse events were documented in 34.0% of patients, and 26.7% had stopped by follow-up, with myalgia the most commonly reported event among those discontinuing.
Why it is interesting: One in four patients stopped within three months, and the fall in LDL depended on existing treatment.
Abstract — the authors' own words, CC BY
Background
Dyslipidaemia remains a leading cause of death in Germany despite an improving therapeutic landscape, with many patients not achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals. Bempedoic acid, an adenosine triphosphate citrate lyase inhibitor, is a recent addition to the therapeutic landscape with proven efficacy in randomised controlled trials; however, its use varies between centres. We aimed to assess the short-term, real-world effectiveness of bempedoic acid in lowering LDL-C levels in patients in Germany. Methods
This retrospective, observational study was conducted using data from patients with primary hypercholesterolaemia or mixed dyslipidaemia, collected before and approximately 3 months after initiating bempedoic acid in 7 specialised lipid outpatient clinics in Germany. Results
Data were analysed from a total of 641 patients, with a mean age (standard deviation [SD]) of 63.2 (11.3) years. The addition of bempedoic acid significantly reduced LDL-C levels from a mean of 133.6 mg/dL at baseline to 101.8 mg/dL after 3 months (p Conclusions
Findings from this real-world, multicentre study conducted in Germany show that bempedoic acid may present an effective treatment option for patients with hypercholesterolaemia who are already receiving LLT, in addition to being an effective option for patients not receiving/tolerating other LLTs. The magnitude of LDL-C reduction differed across background treatment strategies, while suspected adverse events and treatment discontinuation were common in this specialist-care cohort.
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