Cholesterol-lowering drug may help people who can't or won't take statins. Bempedoic acid, a daily pill already approved by the Food and Drug Administration, significantly lowers cholesterol and the risk of heart attacks, new research finds.
People who are unwilling or unable to take statins have limited options for other cholesterol-lowering medications. One possible choice is bempedoic acid, which was approved by the U.S. Food and Drug Administration (FDA) in 2020.
By Lauran Neergaard • Published March 6, 2023
shows the cholesterol-lowering drug Nexletol made by Esperion Therapeutics Inc. Drugs known as statins are the first-choice treatment for high cholesterol but millions of people who can't or won't take those pills because of side effects may have another option.
There are many non-statin medications your doctor might prescribe: Bile acid-binding resins, like cholestyramine (Locholest, Prevalite, Questran), colesevelam (WelChol), and colestipol (Colestid) stick to cholesterol-rich bile acids in your intestines and lower your LDL levels.
The new bempedoic acid drug – currently called Nexletol – is being developed by US-based Esperion Therapeutics and will go to the Therapeutics Goods Administration for approval for use in Australia. Professor Nicholls said he expected the drug to be available for Australian patients in the next two years.
In Australia, statins are recommended for people who have, or are at high risk of, cardiovascular disease. There are several different types of statins, including atorvastatin (Lipitor), rosuvastatin (Crestor), pravastatin, fluvastatin and simvastatin.
A low-dose statin like atorvastatin (Lipitor®) is safe for most patients, including those with mild liver enzyme abnormalities. Many people have fatty liver disease due to obesity.
The American College of Cardiology and American Heart Association developed some prescription guidelines. Typically, if a person's LDL cholesterol (bad cholesterol) is 190 or higher, they're often advised to start a statin.
If you're taking a statin medication to lower your cholesterol, you will need to keep taking your prescription, or your cholesterol will likely go back up. Stopping your statin can put you at risk of having heart disease and other preventable health problems like stroke and heart attack from high cholesterol.
Fear of side effects and perceived side effects are the most common reasons for declining or discontinuing statin therapy. Willingness to take a statin is high, among both patients who have declined statin therapy and those who have never been offered one.
Ezetimibe. Ezetimibe is a tablet that lowers cholesterol. It may be prescribed if statins cannot be taken, or alongside a statin for extra cholesterol-lowering. It's a 'cholesterol absorption inhibitor' that limits the absorption of cholesterol in the small intestine.
Adults age 75 and older may not need statins.
Their doctors usually prescribe statins to prevent heart disease. But for older people, there is no clear evidence that high cholesterol leads to heart disease or death.
A newer drug called Nexletol was approved in 2020 by the FDA to treat high cholesterol, but the new study published in NEJM shows that the drug also reduces the risk of heart disease. Researchers believe this data supports using Nexletol as a safe and effective alternative for many people who cannot take statins.
As a general guide, total cholesterol levels should be: 5mmol/L or less for healthy adults. 4mmol/L or less for those at high risk.
Atorvastatin or fluvastatin are usually recommended because there is no need to adjust the dose according to the glomerular filtration rate [28]. In patients without diagnosed atherosclerotic cardiovascular disease, it is indicated a moderate dose of statin, such as atorvastatin 20 mg daily [28].
It's possible, although unlikely, that one particular statin may cause side effects for you while another statin won't. It's thought that simvastatin (Zocor) may be more likely to cause muscle pain as a side effect than other statins when it's taken at high doses. Change your dose.
Statins are the most common medicine for high cholesterol. They reduce the amount of cholesterol your body makes.
Statin drugs lower LDL cholesterol by slowing down the liver's production of cholesterol. They also increase the liver's ability to remove LDL cholesterol that is already in the blood. Bile acid sequestrants help remove cholesterol from the bloodstream by removing bile acids.
Repatha® (evolocumab) will be extended on the PBS to include more people who have high cholesterol (hypercholesterolaemia). High cholesterol continues to be a major risk factor for developing cardiovascular disease.