Statin Alternative Lowers Risk of Heart Disease Deaths

This content originally appeared on Everyday Health. Republished with permission.

By Lisa Rapaport

There’s a daily pill that may help lower “bad” cholesterol and reduce deaths from heart disease in people who experience intolerable side effects with statins, a new study suggests.

The study included about 4,200 patients with statin intolerance, or an inability to continue statin therapy due to side effects, who were randomly assigned to either a daily bempedoic acid pill or a placebo. All the participants had dangerously high levels of low density lipoprotein (LDL) cholesterol that put them at high risk for heart attacks and strokes.

After about 40 months of follow-up, patients on bempedoic acid were 30 percent less likely to die of cardiovascular causes or experience events like heart attacks or strokes than people in the placebo group, according to study results published June 24 in JAMA.

“This is a huge reduction,” says the lead study author, Steven Nissen, MD, a cardiologist at the Cleveland Clinic who presented the findings at the annual meeting of the American Diabetes Association in San Diego.

Why Do Doctors Prescribe Statins?

Cholesterol-lowering statins have long been recommended to prevent repeat heart attacks in people with high cholesterol levels. More recently, leading medical groups like the American Heart Association and the American College of Cardiology have recommended that people without any history of heart disease consider statins if they have certain cardiovascular disease risk factors, such as obesity, type 2 diabetes, high blood pressure, elevated cholesterol, or a smoking habit.

But only about half of people who should take statins to prevent a first heart attack do it, Dr. Nissen says. “We’ve got to do better than treating only 50 percent of eligible patients,” he says.

Muscle pain is among the most common side effects of statins, according to the Mayo Clinic. Other side effects include elevated blood sugar and an increased risk of type 2 diabetes, liver damage, and neurological side effects like memory loss and confusion. Certain people are at increased risk of these side effects, including females, elderly individuals, people with kidney or liver disease, heavy drinkers, and people who take multiple medicines to lower cholesterol.

What Is Bempedoic Acid (Nexletol)?

Bempedoic acid (Nexletol), the drug tested in the new study, is currently approved by the U.S. Food and Drug Administration (FDA) to lower cholesterol in certain patients with an inherited type of dangerously high cholesterol and certain people with atherosclerosis, a hardening and thickening of the arteries that can increase the risk of heart attacks and strokes.

In the most recent study, bempedoic acid lowered LDL cholesterol levels by 22 percent.

Just 5.3 percent of patients taking this drug died of cardiovascular causes or had events like heart attacks or strokes, compared with 7.6 percent of people taking a placebo pill. This translates into a 30 percent lower risk of death from heart disease or serious cardiac events. These results echo previous studies that found similar LDL cholesterol-lowering effects.

Prevention Is Key When It Comes to Heart Disease

There were no serious side effects with bempedoic acid during the study, although lab tests found that patients on the drug had more markers of problems in the kidney and liver with this drug than with the placebo. In addition, the study found no difference in the rate of new type 2 diabetes cases between bempedoic acid and the placebo.

These results are a “wake-up call” that more patients should be treated with cholesterol-lowering drugs, Nissen says. “We know early prevention measures are critical to slowing the progression of heart disease, especially for people with comorbidities like diabetes,” Nissen adds.

Additional reporting by Ross Wollen.

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