Statins are regularly used by millions of people globally as a way of lowering cholesterol and preventing cardiovascular disease. As health professionals continue to debate the effectiveness of the medication, new research has found a new statin drug could do wonders at lowering levels of low-density lipoprotein (LDL), or the bad cholesterol, while minimising muscle aches that can be associated with the drug.
Described by researchers at the American College of Cardiology as a statin add-on, researchers found patients at higher risk of heart attacks and strokes who took an investigational drug called bempedoic acid in addition to a statin had significantly lower levels of LDL after using the medication for 12 weeks. Patients who took a placebo in addition to statin therapy weren’t as likely to see a reduction in LDL levels.
Researchers noticed patients who used bempedoic acid saw LDL levels reduce by 17.4 per cent after 12 weeks of treatment. The reduction was sustained at 52 weeks of treatment, compared with patients who received a placebo, with no differences in overall adverse effects, including serious adverse events and muscle-related side effects.
“These findings – taken together with other recently reported results of large randomised trials of bempedoic acid – indicate that this agent may add to the armamentarium of treatment options for high-risk patients with atherosclerotic cardiovascular disease whose LDL cholesterol remains uncontrolled despite taking a maximally tolerated statin,” lead author Anne C. Goldberg said.
Previous studies have shown statins can be an effective way at lowering cholesterol levels and reducing the risk of heart attacks and strokes. Statins work by blocking an enzyme that the liver uses to make cholesterol, but also inhibit cholesterol production in the muscles. A common side effect of statin use is muscle pain, with 10 per cent of patients on high doses reporting muscle pain.
Bempedoic acid works by also blocking the liver from making cholesterol, but doesn’t block cholesterol production in muscles. Researchers believe the drug may be less likely to cause muscle pain and promote further reduction of LDL cholesterol levels in patients who need to limit their statin doses.
The latest study analysed 779 patients with an average age of 64 and LDL cholesterol levels of at least 100 mg/dL. Each patient was also taking the highest tolerated dose of statins. As well as atherosclerotic cardiovascular disease, 80 per cent of patients reported high blood pressure, 30 per cent had diabetes, while 6 per cent had familial hypercholesterolemia, a condition which causes high LDL cholesterol and elevates risk for a heart attack from an early age.
Participants were given either a bempedoic acid 180 mg tablet once a day or an identical placebo tablet daily in addition to their statins. Patients and doctors didn’t know which medication they received. At 12 weeks, LDL levels declined from an average of 119.4 mg/dL to 97.6 mg/dL for those taking bempedoic acid. At one year, bempedoic acid users had an average LDL cholesterol level of 99.6 mg/dL, while for those in the placebo group the average was 116.9 mg/dL.
“The effect of bempedoic acid was durable at one year and we observed no increase in adverse effects from the addition of bempedoic acid to statin therapy,” Goldberg explained.
A global randomised, double-blinded, placebo-controlled trial is currently underway to determine whether treatment with bempedoic acid decreases the risk of heart attacks, strokes and death from heart or blood-vessel disease in patients who can tolerate less than the lowest approved daily starting dose of a statin. Around 12,600 patients from 30 countries are completed in the latest trial, which is expected to be completed in 2022.
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