Affiliation:
1. Department of Pharmacy Federico II University Naples, Italy
2. Department of Molecular Medicine and Medical Biotechnology Federico II University Naples, Italy
3. Department of Clinical Medicine and Surgery Federico II University Naples, Italy
4. Centro Cardiologico Monzino IRCCS Milan, Italy
5. Postgraduation School in Radiodiagnostics Università Degli Studi di Milano Milan, Italy
6. Istituti Clinici Scientifici Maugeri IRCCS Pavia, Italy
7. Department of Translational Medical Sciences Federico II University Naples Italy
Abstract
Background
Bempedoic acid (
BA
) is a novel lipid‐lowering drug. We performed a systematic review and meta‐analysis on efficacy and safety of
BA
compared with standard treatment in patients with hypercholesterolemia.
Methods and Results
Studies were systematically searched in the PubMed, Web of Science, Scopus, and
EMBASE
databases. Efficacy outcome was represented by percentage changes (mean difference [
MD
] with pertinent 95%
CIs
) in total cholesterol, low‐density lipoprotein cholesterol, triglycerides, high‐density lipoprotein cholesterol, apolipoprotein B, non–
high‐density lipoprotein cholesterol
, and hs‐CRP (high‐sensitivity C‐reactive protein) in
BA
patients and controls. Seven studies were included (2767
BA
‐treated patients and 1469 controls), showing a more significant reduction in
low‐density lipoprotein cholesterol
(
MD
, −17.5%; 95%
CI
, −22.9% to −12.0%),
total cholesterol
(
MD
, −10.9%; 95%
CI
, −13.3% to −8.5%), non–
high‐density lipoprotein cholesterol
(
MD,
−12.3%; 95%
CI
, −15.3% to −9.20%), apolipoprotein B (
MD
, −10.6%; 95%
CI
, −13.2% to −8.02%), and hs‐CRP (
MD
, −13.2%; 95%
CI
, −16.7% to −9.79%) in
BA
‐treated patients compared with controls. Results were confirmed when separately analyzing studies on patients with high cardiovascular risk, studies on statin‐intolerant patients, and studies on patients with hypercholesterolemia on maximally tolerated lipid‐lowering therapy.
BA
‐treated subjects reported a higher rate of treatment discontinuation caused by adverse effects, of gout flare, and of increase in uric acid compared with controls. On the other hand,
BA
‐treated patients showed a lower incidence of new‐onset diabetes mellitus than controls.
Conclusions
BA
is associated with a significant reduction in
low‐density lipoprotein cholesterol
,
total cholesterol
, non–
high‐density lipoprotein cholesterol
, apolipoprotein B, and hs‐CRP compared with standard treatment. Documented efficacy is accompanied by an acceptable safety profile.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
45 articles.
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