Statin Alternative Treats Cholesterol With Fewer Side Effects

3 min read

March 6, 2023 – For people who don’t take common cholesterol medications due to side effects such as muscle aches, a new study suggests taking a drug called bempedoic acid may be more tolerable and still offer sizable protection for their hearts.

Results showed that taking bempedoic acid lowered LDL (low-density lipoprotein) cholesterol by 21% in 6 months and reduced the risk of heart attack by 23%. LDL is the “bad" cholesterol that can collect in your arteries and lead to heart attacks, strokes, and other problems.

The drug also reduced the combined risk of any of the following occurring by 13%: heart attack, stroke, needing treatment for a blocked artery, or death from disease of the heart or blood vessels.

The study was conducted by the Cleveland Clinic and funded by drugmaker Esperion Therapeutics, which markets bempedoic acid under the brand name Nexletol. Bempedoic acid is already FDA approved but this study may help the treatment become covered by insurance policies, The New York Timesreported.

People who already take cholesterol medications called statins should keep doing so, though, said study director Steven E. Nissen, MD, of the Cleveland Clinic. 

“Most people can take statins, but some cannot,” he said in a statement. “This is the first study that directly addressed the problem of statin-intolerant patients. We achieved what we hoped we would get — a very positive result in a population of people who just could not tolerate statins.” 

Results were published Saturday in The New England Journal of Medicine. They were also presented at the American College of Cardiology’s annual meeting in New Orleans. The study compared the effects of taking bempedoic acid to taking a placebo pill among 14,000 people who couldn’t or wouldn’t take statins due to side effects but who had or were at risk for heart disease. The study lasted a little over three years.

More than 1 in 10 people in the U.S. have high cholesterol, which is a risk factor for heart disease, according to the CDC. In 2021, almost 700,000 people in the U.S. died of heart disease, making it the nation’s leading cause of death.

While how well bempedoic acid works is not as good as statins, study results offer a new option for people who are skipping treatment altogether. As many as 29% of people who should take a statin are unwilling or unable to do so because they cannot tolerate side effects like muscle aches.

Statins are twice as good as bempedoic acid at managing cholesterol levels. They are so much better than bempedoic acid or other alternatives, that people who have quit statins should consider restarting them, experts say.

“It is premature, however, to consider bempedoic acid as an alternative to statins,” John H. Alexander, M.D., said in an editorial published alongside the study. “Given the overwhelming evidence of the vascular benefits of statins, clinicians should continue their efforts to prescribe them at the maximum tolerated doses for appropriate patients, including those who may have discontinued statins because of presumed side effects.”