Rankings / Cardiovascular & Lipids
Bempedoic acid
CV/Lipid · ACL inhibitor
Tier C+
What this is
CLEAR Outcomes 2023 finally gave statin-intolerant patients a non-statin oral with CV outcome data. Gout flares are a real side effect — screen for baseline uric acid. Expensive relative to ezetimibe with similar LDL reduction.
Mechanism
ATP-citrate lyase inhibitor; blocks cholesterol synthesis upstream of HMG-CoA reductase; prodrug activated only in liver (bypasses muscle → less myalgia); ~20% LDL reduction monotherapy; CLEAR Outcomes trial showed CV benefit
Dose & route
180 mg PO daily
Citations
- https://pubmed.ncbi.nlm.nih.gov/36876740/
- https://pubmed.ncbi.nlm.nih.gov/30415637/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7034386/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.