Bempedoic acid 180mg / Ezetimibe 10mg tablets

BACKGROUND The management of LDL-C levels is pivotal in the prevention of cardiovascular morbidity, particularly among patients at high risk or those intolerant to statins. Bempedoic acid emerges as a novel agent in this therapeutic arena. OBJECTIVES This systematic review and meta-analysis endeavor to quantify the effectiveness of Bempedoic acid in attenuating LDL-C levels and explore its impact on cardiovascular morbidity, emphasizing its role as an adjunctive or alternative therapy in statin-intolerant or high-risk patients. METHODS A comprehensive search spanning PubMed, Google Scholar, and Cochrane Library databases furnished studies for this review. The inclusion was critiqued based on predefined PICOS parameters, ensuring a robust analytical framework. RESULTS Bempedoic acid showcased a significant plunge in LDL-C levels (MD -20.69%, 95% CI [-23.20, -18.19]), outperforming placebo and ezetimibe monotherapy. The cardioprotective effect was further echoed with a reduced risk of major adverse cardiac events (MACE) in the Bempedoic acid cohort (RR 0.86, 95% CI [0.80, 0.94]). However, a dive into the safety profile revealed no substantial augmentation in adverse events, affirming its tolerance and efficacy. CONCLUSIONS Bempedoic acid represents a potent therapeutic ally, affirming its capacity to significantly pare down LDL-C levels and curtail cardiovascular events. Its favorable safety profile underscores its suitability, especially among those with statin intolerance or individuals categorized within the high-risk vascular bracket, necessitating a paradigm shift in current lipid management strategies.

Abstract licence: CC BY-NC-ND

Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are significant health concerns affecting a large segment of the population and are known to be associated with adverse cardiovascular outcomes. As a result, various lipid-lowering medications are commonly employed in clinical practice to address the elevated cardiovascular risk in these patients. This systematic review summarizes the current evidence on emerging non-statin lipid-lowering therapies-ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, eicosapentaenoic acid (EPA), and bempedoic acid-and their effects on hepatic outcomes in patients with MASLD or MASH. A total of 18 studies involving 933 participants were deemed eligible for inclusion, along with 1 ongoing study included for descriptive analysis. Ezetimibe had the most extensive supporting evidence: 4 of 5 non-randomized studies reported improvements in hepatic enzyme levels, whereas 5 of 8 randomized controlled trials found no significant changes. Imaging results were mixed, with some studies demonstrating reduced hepatic fat content by magnetic resonance imaging or ultrasound, while others found no effect. Histological improvements were observed in non-randomized studies, but randomized trials showed no significant histopathological changes. Only 3 studies on PCSK9 inhibitors were included, of which 2 reported imaging-based improvements in hepatic steatosis. Two studies assessed EPA, but yielded conflicting results, and only 1 ongoing study has examined bempedoic acid. Although preclinical data suggest potential hepatic benefits of these therapies in MASLD, current clinical evidence remains limited and inconsistent, highlighting the need for larger, high-quality trials to establish definitive conclusions.

Abstract licence: CC BY-NC