Efficacy and Outcomes of Bempedoic Acid Versus Placebo in Patients with Statin-Intolerance: A Pilot Systematic Review and Meta-analysis of Randomized Controlled Trials

Authors

Aman Goyal, Medical College and KEM Hospital, Mumbai, IndiaFollow
Mah I khan Changez, Quetta Institute of Medical Sciences, Quetta, PakistanFollow
Muhammad Daoud Tariq Daoud Tariq, Foundation University Medical College, Islamabad, PakistanFollow
Fiza Mushtaq, Allama Iqbal Medical College, Lahore, Pakistan.Follow
Urooj Shamim, Aga Khan UniversityFollow
Amir Humza Sohail, University of New Mexico Health Sciences, Albuquerque, NM, USA.Follow
Gauranga Mahalwar, Cleveland Clinic Foundation, Cleveland, OH, USA.Follow

Document Type

Article

Department

Internal Medicine

Abstract

Introduction: Bempedoic acid (BA) has shown significant progress in reducing cholesterol levels and is relatively free from the many side effects encountered with the use of other hyperlipidemic drugs such as statins. However, its efficacy in patients with statin intolerance is controversial with inconsistent results among studies.
Materials and methods: An electronic literature search was performed using various databases such as Medline, Google Scholar, and the International Registry of Clinical Trials. The primary endpoint was the change in LDL-C levels. The secondary endpoints included changes in HDL-C, non-HDL-C, triglycerides (TG), clinical outcomes such as MACE, all-cause mortality (ACM), cardiovascular mortality, myocardial infarction (MI), and additional safety outcomes. The least-square mean (LSM) percent change for assessing changes in lipid parameter levels from the baseline and the risk ratio (RR) were used for the evaluation of binary endpoints, with statistical significance set at pResults: Our analysis included 5 randomized controlled trials (RCTs) with a total of 18,848 participants. BA showed a significant reduction in LDL-C [LSM difference in %: -25.24; 95% CI: -30.79 to -19.69; pConclusion: Our analysis demonstrated that BA significantly reduced the levels of LDL-C, total cholesterol, non-HDL-C, HDL-C, ApoB, and hs-CRP compared with the placebo group. Additionally, patients who received BA had a lower likelihood of coronary revascularization and hospitalization due to unstable angina, MI, and myalgia. Further large-scale RCTs are required to generate more robust evidence.

Comments

volume, issue and pagination are not provided by the author/publisher.

Publication (Name of Journal)

Current Problems in Cardiology

DOI

https://www.sciencedirect.com/science/article/pii/S0146280623006539?via%3Dihub

Recommended Citation

Goyal, A., Changez, M. I., Tariq, M. D., Mushtaq, F., Shamim, U., Sohail, A. H., Mahalwar, G. (2023). Efficacy and Outcomes of Bempedoic Acid Versus Placebo in Patients with Statin-Intolerance: A Pilot Systematic Review and Meta-analysis of Randomized Controlled Trials. Current Problems in Cardiology.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_intern_med/241