The Latest Evidence on Bempedoic Acid: Meta-Analysis of Safety and Efficacy in High Cardiovascular Risk Patients With Hypercholesterolemia

BA Efficacy High cardiovascular risk LDL-C levels Meta-analysis Safety

Journal

Journal of community hospital internal medicine perspectives
ISSN: 2000-9666
Titre abrégé: J Community Hosp Intern Med Perspect
Pays: United States
ID NLM: 101601396

Informations de publication

Date de publication:
2024
Historique:
received: 24 06 2023
revised: 09 11 2023
accepted: 02 01 2024
medline: 5 7 2024
pubmed: 5 7 2024
entrez: 5 7 2024
Statut: epublish

Résumé

Bempedoic Acid (BA) is a novel drug that has a potential to serve as an alternative to statins to decrease lipid levels and improve cardiovascular disease (CVD) outcomes, particularly for statin-intolerant individuals. However, insufficient statistical power has limited our understanding of the efficacy and safety of BA. This meta-analysis utilizes the latest data to improve our knowledge of BA's effects on lipids and CVD with increased statistical power. MEDLINE, Embase, Cochrane Central, Clinicaltrials.gov, abstracts of national and international conferences, and reference lists of studies were searched for relevant studies. Rayyan was used to screen the search results, and Revman 5.3 was used for the meta-analysis and sensitivity analysis. Our final analysis included seven randomized control trials (RCTs) with 17,782 participants, 53.6 % in the BA group (n = 9535) and 46.4 % in the placebo group (n = 8247). BA significantly decreased major adverse cardiovascular events (MACE) (OR: 0.86; 95 % CI 0.78-0.95; p = 0.03), non-fatal myocardial infarction (OR 0.72; 95 % CI 0.61-0.85; p = 0.0001), and new onset/worsening diabetes (OR:0.55; 95 % CI 0.30-0.98, p = 0.04), while reducing low-density lipoprotein cholesterol (LDL-C) levels by 22.5 % (MD: -22.53 %; 95 % CI -25.54 to -19.52, p < 0.00001). The findings of this meta-analysis suggest that BA is a promising and effective alternative to statin therapy, particularly for statin-intolerant and high CVD-risk patients. However, further studies with diverse populations are needed to quantify the long-term efficacy and safety endpoints.

Sections du résumé

Background UNASSIGNED
Bempedoic Acid (BA) is a novel drug that has a potential to serve as an alternative to statins to decrease lipid levels and improve cardiovascular disease (CVD) outcomes, particularly for statin-intolerant individuals. However, insufficient statistical power has limited our understanding of the efficacy and safety of BA. This meta-analysis utilizes the latest data to improve our knowledge of BA's effects on lipids and CVD with increased statistical power.
Methods UNASSIGNED
MEDLINE, Embase, Cochrane Central, Clinicaltrials.gov, abstracts of national and international conferences, and reference lists of studies were searched for relevant studies. Rayyan was used to screen the search results, and Revman 5.3 was used for the meta-analysis and sensitivity analysis.
Results UNASSIGNED
Our final analysis included seven randomized control trials (RCTs) with 17,782 participants, 53.6 % in the BA group (n = 9535) and 46.4 % in the placebo group (n = 8247). BA significantly decreased major adverse cardiovascular events (MACE) (OR: 0.86; 95 % CI 0.78-0.95; p = 0.03), non-fatal myocardial infarction (OR 0.72; 95 % CI 0.61-0.85; p = 0.0001), and new onset/worsening diabetes (OR:0.55; 95 % CI 0.30-0.98, p = 0.04), while reducing low-density lipoprotein cholesterol (LDL-C) levels by 22.5 % (MD: -22.53 %; 95 % CI -25.54 to -19.52, p < 0.00001).
Conclusion UNASSIGNED
The findings of this meta-analysis suggest that BA is a promising and effective alternative to statin therapy, particularly for statin-intolerant and high CVD-risk patients. However, further studies with diverse populations are needed to quantify the long-term efficacy and safety endpoints.

Identifiants

pubmed: 38966502
doi: 10.55729/2000-9666.1305
pii: jchim-14-02-012
pmc: PMC11221435
doi:

Types de publication

Journal Article

Langues

eng

Pagination

12-22

Informations de copyright

© 2024 Greater Baltimore Medical Center.

Déclaration de conflit d'intérêts

Declaration of competing interest: The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication.

Auteurs

Muhammad A Afzal (MA)

Department of Internal Medicine, St Joseph's University Medical Center, Paterson, NJ, USA.

Noman Khalid (N)

Department of Internal Medicine, St Joseph's University Medical Center, Paterson, NJ, USA.

Muhammad Abdullah (M)

Department of Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Shaikh Zayed Medical Complex, Lahore, Pakistan.

Ata U Haiy (AU)

Department of Medicine, King Edward Medical University, Mayo Hospital Lahore, Pakistan.

Mubariz A Hassan (MA)

Department of Internal Medicine, Howard University Hospital, Washington, DC, USA.

Hania Sana (H)

Department of Medicine, King Edward Medical University, Mayo Hospital Lahore, Pakistan.

Sherif Elkattawy (S)

Department of Cardiology, St Joseph's University Medical Center, Paterson, NJ, USA.

Ahmad A Malik (AA)

Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.

Patrick Michael (P)

Department of Internal Medicine, St Joseph's University Medical Center, Paterson, NJ, USA.

Rahul Vasudev (R)

Department of Structural Heart Disease, St Joseph's University Medical Center, Paterson, NJ, USA.

Fayez Shamoon (F)

Department of Cardiology, St Joseph's University Medical Center, Paterson, NJ, USA.

Classifications MeSH