Endocrine Abstracts

Bempedoic acid, an innovative medication targeting cholesterol synthesis through ATP citrate lyase inhibition, gained FDA and EMA approval in February 2020 for familial hypercholesterolemia and cardiovascular disease. UK NICE TA694, on April 28, 2021, extended its recommendation to include Bempedoic acid with ezetimibe for primary hypercholesterolaemia and mixed dyslipidaemia in adults, alongside dietary measures. This retrospective clinical audit assessed Bempedoic acid’s effectiveness and safety, particularly in patients intolerant to statins, familial hyperlipidaemia, and atherosclerotic cardiovascular disease. Examining 16 patients from the Leigh Lipid Clinic (January 2021 to June 2023), results showed a significant reduction in LDL-C levels, with a peak percentage reduction of 18.98% at 6 months. Total cholesterol reached its lowest mean at 6 months, with a maximum reduction of 13.51%. However, a notable percentage of patients developed prediabetes or diabetes, warranting further exploration. Contrary to expectations, triglyceride levels increased by 30.4%, challenging previous literature suggesting Bempedoic acid’s benefits in diabetes patients. In the audit of Bempedoic acid treatment for hypercholesterolemia in 16 patients, all participants experienced at least one treatment-emergent adverse event (TEAE), but none led to treatment discontinuation. New onset hypertension occurred in 12.5% of patients, while musculoskeletal symptoms and other specific adverse events, were reported in smaller percentages. Biochemical changes, such as elevated creatine kinase and alanine aminotransferase levels, as well as shifts in HbA1c with some patients transitioning to diabetes or prediabetes, were observed. Notably, 45.5% of patients had a significant drop in hemoglobin levels. Descriptive statistics of urea levels over time revealed a notable increase at the 1-year mark, reaching a mean of 7.75 mmol/l, with a maximum observed percentage increase of 30.64%. Triglyceride levels peaked at the 6-month interval with a mean of 2.6 mmol/l and a maximum observed percent increase of 30.4%. HDL-C levels showed the lowest mean at the 6-month interval (1.1725 mmol/l) with a maximum observed percent reduction of -28.08%. These findings highlight the prevalence of adverse events and biochemical changes associated with Bempedoic acid treatment, emphasizing the need for careful monitoring and further investigation. Acknowledging study limitations, such as a small sample size and missing data, this research provides valuable insights into Bempedoic acid’s safety and side effects in a challenging patient population, advocating for a larger sample size in future evaluations.