Stroke Research & Therapy

Description

In the dynamic landscape of lipid-lowering therapeutics, bempedoic acid has recently emerged as a subject of intense interest for its potential in managing hypercholesterolemia. Hypercholesterolemia, characterized by elevated levels of Low- Density Lipoprotein Cholesterol (LDL-C), poses a substantial risk for cardiovascular diseases and the need for effective alternatives to traditional statin therapy is particularly evident in patients experiencing statin intolerance.

This study undertakes a comprehensive quantitative metaanalysis to unravel the safety and efficacy profile of bempedoic acid, aiming to provide a nuanced understanding of its role in cardiovascular health. Bempedoic acid represents a novel inhibitor of cholesterol synthesis specifically targeting ATP Citrate Lyase (ACL). Significantly, bempedoic acid undergoes activation exclusively within the liver, ensuring its efficacy while remaining free from muscle-related side effects [1]. The primary objective of this research is to systematically assess and quantify the safety profile of bempedoic acid in comparison to a placebo. Simultaneously, the study seeks to evaluate the efficacy of bempedoic acid in reducing LDL-C levels, with a specific focus on discerning outcomes between patients with statin intolerance and those without.

The rationale for this investigation lies in the gaps present in the existing body of evidence surrounding bempedoic acid. Despite its promising potential, the outcomes of initial investigations lack definitive clarity. By synthesizing data from randomized controlled trials, this study strives to bridge this knowledge gap, contributing valuable insights to inform clinical decision-making and guide future research endeavors.

To achieve these objectives, an exhaustive search was conducted on ClinicalTrials.gov and PubMed, covering studies from their inception until September 28, 2023. The inclusion criteria focused on randomized controlled trials that directly compared the safety and efficacy of bempedoic acid in patient cohorts with and without statin intolerance. Rigorous analysis utilizing a random effects model is employed to present mean differences or Odds Ratios (ORs) with a 95% confidence interval, with additional considerations given to trial heterogeneity and potential bias.

Anticipating a multifaceted contribution, this study not only aims to provide clinicians, researchers and policymakers with a robust synthesis of existing evidence but also seeks to address the intricacies of bempedoic acid's safety and efficacy. Bempedoic acid has the potential to contribute to the reduction of cardiovascular disease risk not only as monotherapy, but even further as part of a lipid-lowering combination therapy with ezetimibe, reducing LDL-C cholesterol up to 40% [2]. Beyond the established 'the lower, the better' strategy, adopting a 'strike early and strike strong' approach during the early post-acute coronary syndrome phase appears justified. This involves promptly initiating a comprehensive lipid-lowering strategy using high-intensity statins and ezetimibe for optimal efficacy [3]. Bempedoic acid, both as a standalone treatment and in combination with ezetimibe, has obtained approval from the U.S. FDA for use in adults diagnosed with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease [4]. The nuanced insights generated by this metaanalysis are expected to facilitate informed decision-making regarding the integration of bempedoic acid into clinical practice, offering a pivotal contribution to the ongoing discourse surrounding innovative therapies for hypercholesterolemia.

Conclusion

In conclusion, through a meticulous examination of bempedoic acid's impact on cardiovascular health, this study endeavors to enhance our understanding of its potential role in shaping the future landscape of lipid-lowering interventions.

Acknowledgment

We extend gratitude to all researchers whose work contributed to the trials included in this meta-analysis.

Conflict of Interest

The authors declare no conflicts of interest related to this research.

References

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