Language
English
Publication Date
12-1-2024
Journal
Cardiovasc Drugs and Therapy
DOI
10.1007/s10557-023-07474-9
PMID
37261676
PMCID
PMC11680617
PubMedCentral® Posted Date
6-1-2023
PubMedCentral® Full Text Version
Post-print
Abstract
Purpose: Statins are first-line agents to reduce low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk, however, they are insufficient and/or intolerable in many patients. To that end, we conducted a meta-analysis of Bempedoic Acid (BA), a novel LDL-C lowering agent.
Methods: We retrieved randomized clinical trials (RCTs) of BA by searching Pubmed, the Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov. We used the Mantel-Haenszel method to pool estimates. The I2 measure was used to quantify heterogeneity. Treatment effects are provided as relative risks (RR), absolute risk differences (ARD), and number needed to treat/harm (NNTB/H). Analyses were conducted using R, version 4.1.2.
Results: 11 trials enrolling 18,496 patients were included. Compared to placebo, BA reduced the risk of major adverse cardiovascular events (RR: 0.87; 95% CI: 0.80 to 0.95; ARD: -1.63%; NNT: 62), myocardial infarction (RR: 0.76; 95% CI: 0.66 to 0.89; ARD: -1.03%; NNT: 98), unstable angina hospitalization (RR: 0.70; 95%: CI: 0.55 to 0.89; ARD: -0.57%; NNT: 177), revascularization (RR: 0.81; 95% CI: 0.72 to 0.91; ARD: -1.31%; NNT: 77), and myalgia (RR: 0.85; 95% CI: 0.75 to 0.95; ARD: -0.99%; NNT: 102). BA significantly increased the risk of gout (RR: 1.56; 95% CI: 1.27 to 1.91; ARD: 0.99%; NNH: 101), renal impairment (RR: 1.35; 95% CI: 1.22 to 1.49; ARD: 2.54%; NNH: 40), and cholelithiasis (RR: 1.87; 95% CI: 1.43 to 2.44; ARD: 1.01%; NNH: 100).
Conclusion: BA effectively reduces the risk of cardiovascular events and myalgia but increases the risk of gout, cholelithiasis, and renal impairment.
Keywords
Humans, Cardiovascular Diseases, Cholesterol, LDL, Dicarboxylic Acids, Fatty Acids, Heart Disease Risk Factors, Randomized Controlled Trials as Topic, Treatment Outcome, Bemepdoic Acid, Atherosclerotic cardiovascular disease, Low-density lipoprotein cholesterol, Statin intolerance, Meta-analysis
Published Open-Access
yes
Recommended Citation
Sayed, Ahmed; Shazly, Omar; Slipczuk, Leandro; et al., "The Clinical Efficacy and Safety of Bempedoic Acid in Patients at Elevated Risk of Cardiovascular Disease: A Meta-Analysis of Randomized Clinical Trials" (2024). Faculty and Staff Publications. 4301.
https://digitalcommons.library.tmc.edu/baylor_docs/4301