Bempedoic acid is a novel non-statin lipid lowering drug that inhibits cholesterol biosynthesis in the same pathway as statins. It reduces the cholesterol synthesis in liver and helps clear the bad cholesterol (LDL-cholesterol) from bloodstream. Thus protecting from cardiovascular events like heart attack, strokes, etc.
Rx
Bempedoic acid will be launched in India this year. It is available in the U.S. – 180 mg once a day dosage.
Advantages
It lowers lipids in statin intolerant patients. It is administered as a prodrug and is converted to active drug only in the liver and not muscles. It is a cheaper alternative to PCSK9 inhibitors (a potent lipid lowering drug) which is in injectable form.
Ezetimibe (another lipid lowering oral drug) causes 21 per cent LDL-C reduction when used as monotherapy while bempedoic acid, on other hand, reduced LDL-C by 30 per cent at 12 weeks at a dose of 180 mg daily. A combination of bempedoic acid and ezetimibe resulted in 48 per cent LDL-C reduction at 12 weeks.
Side effects
• Hyperuricemia and gout symptoms
• Increased risk of tendon rupture involving the biceps tendon, rotator cuff, or Achilles tendon
• Upper respiratory tract infection, bronchitis
• Back pain
• abdominal pain or discomfort
• pain in extremity
• anaemia and elevated liver enzymes.
Word of caution
Bempedoic acid should not be taken by those who:
• have a history of gout
• are over 60 years of age
• are taking corticosteroid or fluoroquinolone drugs
• have renal failure
• have previous tendon disorders.
• have hypersensitivity to the active substance
• are pregnant or breastfeeding
