Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review
Dyslipidaemia is one of the main causes of atherosclerotic cardiovascular disease (ASCVD) worldwide. Although statins remain the cornerstone of lipid-lowering therapy, many patients do not achieve optimal target levels of low-density lipoprotein cholesterol (LDL-C) due to intolerance or inadequate r...
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2025-06-01
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| author | Dominik Strikic Zvonimir Begic Ivana Radman Fran Zlopasa Jana Mateljic Ivica Zec Marina Titlic Ana Marija Sliskovic Ivan Pecin Zeljko Reiner Iveta Mercep |
| author_facet | Dominik Strikic Zvonimir Begic Ivana Radman Fran Zlopasa Jana Mateljic Ivica Zec Marina Titlic Ana Marija Sliskovic Ivan Pecin Zeljko Reiner Iveta Mercep |
| author_sort | Dominik Strikic |
| collection | DOAJ |
| description | Dyslipidaemia is one of the main causes of atherosclerotic cardiovascular disease (ASCVD) worldwide. Although statins remain the cornerstone of lipid-lowering therapy, many patients do not achieve optimal target levels of low-density lipoprotein cholesterol (LDL-C) due to intolerance or inadequate response. Bempedoic acid, an oral ATP citrate lyase inhibitor, provides a liver-specific mechanism that lowers LDL-C levels while minimising muscle-related side effects. Recent clinical trials, including the CLEAR Outcomes Study, have shown that bempedoic acid was able to reduce LDL-C by approximately 29 mg/dL and major adverse cardiovascular events (MACEs) by 13% in patients intolerant to statins. Combination therapy with ezetimibe further enhances this effect. However, adverse effects such as increased uric acid and gout have been reported, requiring careful patient selection and continuous monitoring. This review provides a comparative synthesis of the latest evidence on bempedoic acid, including its pharmacological profile, its efficacy in different patient groups, and its place within current treatment strategies for dyslipidaemia. It also identifies research gaps and directions for future studies. |
| format | Article |
| id | doaj-art-aba61c0aa272448ca77e1bf4dc4ef28d |
| institution | Matheson Library |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Biomedicines |
| spelling | doaj-art-aba61c0aa272448ca77e1bf4dc4ef28d2025-06-25T13:32:04ZengMDPI AGBiomedicines2227-90592025-06-01136146010.3390/biomedicines13061460Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative ReviewDominik Strikic0Zvonimir Begic1Ivana Radman2Fran Zlopasa3Jana Mateljic4Ivica Zec5Marina Titlic6Ana Marija Sliskovic7Ivan Pecin8Zeljko Reiner9Iveta Mercep10Division of Clinical Pharmacology, University Hospital Centre Zagreb, 10 000 Zagreb, CroatiaDivision of Plastic and Reconstructive Surgery, University Hospital Centre Zagreb, 10 000 Zagreb, CroatiaDepartment of Ophthalmology, Sestre Milosrdnice University Hospital Centre, 10 000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10 000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10 000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10 000 Zagreb, CroatiaSchool of Medicine, University of Split, 21 000 Split, CroatiaDepartment of Cardiology, University Hospital Centre Zagreb, 10 000 Zagreb, CroatiaDepartment of Internal Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, CroatiaDepartment of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, PolandDepartment of Internal Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, CroatiaDyslipidaemia is one of the main causes of atherosclerotic cardiovascular disease (ASCVD) worldwide. Although statins remain the cornerstone of lipid-lowering therapy, many patients do not achieve optimal target levels of low-density lipoprotein cholesterol (LDL-C) due to intolerance or inadequate response. Bempedoic acid, an oral ATP citrate lyase inhibitor, provides a liver-specific mechanism that lowers LDL-C levels while minimising muscle-related side effects. Recent clinical trials, including the CLEAR Outcomes Study, have shown that bempedoic acid was able to reduce LDL-C by approximately 29 mg/dL and major adverse cardiovascular events (MACEs) by 13% in patients intolerant to statins. Combination therapy with ezetimibe further enhances this effect. However, adverse effects such as increased uric acid and gout have been reported, requiring careful patient selection and continuous monitoring. This review provides a comparative synthesis of the latest evidence on bempedoic acid, including its pharmacological profile, its efficacy in different patient groups, and its place within current treatment strategies for dyslipidaemia. It also identifies research gaps and directions for future studies.https://www.mdpi.com/2227-9059/13/6/1460dyslipidaemiabempedoic acidstatin intolerancecardiovascular risklipid-lowering therapy |
| spellingShingle | Dominik Strikic Zvonimir Begic Ivana Radman Fran Zlopasa Jana Mateljic Ivica Zec Marina Titlic Ana Marija Sliskovic Ivan Pecin Zeljko Reiner Iveta Mercep Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review Biomedicines dyslipidaemia bempedoic acid statin intolerance cardiovascular risk lipid-lowering therapy |
| title | Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review |
| title_full | Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review |
| title_fullStr | Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review |
| title_full_unstemmed | Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review |
| title_short | Reshaping Dyslipidaemia Treatment with Bempedoic Acid—A Narrative Review |
| title_sort | reshaping dyslipidaemia treatment with bempedoic acid a narrative review |
| topic | dyslipidaemia bempedoic acid statin intolerance cardiovascular risk lipid-lowering therapy |
| url | https://www.mdpi.com/2227-9059/13/6/1460 |
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