Effect of Bempedoic Acid on atherogenic lipids and inflammation: A meta-analysis

Abstract

Background: Bempedoic acid is a novel non-statin drug that was developed to treat hyperlipidemia in combination with other lipid-lowering drugs in those patients who need additional lipid lowering.

Objectives: (1) To investigate the lipid efficacy of bempedoic acid; (2) to analyze the anti-inflammatory effects of bempedoic acid estimated through high sensitivity C-reactive protein (hsCRP).

Methods: We performed a meta-analysis including randomized trials of bempedoic acid therapy, reporting low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B and hsCRP with a minimum of 4 weeks of follow-up. The primary endpoint was defined as the percentage change in lipids and hsCRP levels measured from baseline to follow-up, comparing groups of subjects on bempedoic acid versus placebo.

Results: Seven eligible trials of bempedoic acid (3892 patients) were included. The bempedoic acid therapy was associated with a significant reduction in LDL-C levels [-20.3% (CI 95% -23.5 to -17.1)]; I²=43%]. Similarly, a significant percentage reduction in the apolipoprotein B levels [-14.3% (CI 95% -16.4 to -12.1)]; p<0.05; I²=46%], non-HDL-C levels [-15.5% (CI 95% -18.1 to -13.0)]; p<0.05; I²=53%] and hsCRP [-23.4% (CI 95% -32.6 to -14.2)]; p<0.05; I²=69%] was demonstrated with the bempedoic acid use. The sensitivity analysis showed that the results were robust.

Conclusion: Our data suggests that the use of bempedoic acid significantly reduces the levels of all atherogenic lipid markers, including LDL-C, non-HDL-C and apolipoprotein B. Furthermore, considering hsCRP levels, the drug produces an anti-inflammatory effect.

Keywords: Apolipoprotein B; Apolipoproteína B; Bempedoic acid; Colesterol de lipoproteína de baja densidad; Colesterol de lipoproteína de no alta densidad; High-sensitivity C-reactive protein; Low-density lipoprotein cholesterol; Meta-analysis; Meta-análisis; Non-high-density lipoprotein cholesterol; Proteína C reactiva de alta sensibilidad; Ácido bempedoico.