Vnitr Lek 2025, 71(2):119-123 | DOI: 10.36290/vnl.2025.020

Bempedoic acid - a practical review

Barbora Nussbaumerová

Centrum preventivní kardiologie, II. interní klinika LF a FN v Plzni, UK v Praze

Atherosclerotic cardiovascular diseases (ASCVD) remain the most common cause of morbidity and mortality in developed countries, despite the availability of cardiovascular (CV) prevention strategies and efforts to implement them. Dyslipidemia, particularly hypercholesterolemia, along with arterial hypertension, diabetes, and nicotine dependence, are among the main modifiable risk factors in both primary and secondary prevention of ASCVD. Despite significant progress in the pharmacotherapy of these conditions, including hypercholesterolemia, the recommended target serum lipid levels are not achieved in up to two-thirds of patients. A relatively new addition to the lipid-lowering medications is bempedoic acid, an ATP-citrate lyase inhibitor. It limits the endogenous synthesis of cholesterol, thereby reducing LDL-cholesterol levels and subsequently the incidence of CV events. This new treatment has shown favorable results in clinical trials, particularly in the CLEAR Outcomes study. Bempedoic acid holds promise, especially in combination with ezetimibe in statin-intolerant patients. The article concludes with a practical guide on current indications and reimbursement criteria.

Keywords: bempedoic acid, efficacy, safety, CLEAR Outcomes study, reimbursement criteria.

Accepted: March 18, 2025; Published: March 27, 2025  Show citation