Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 32787939 · doi:10.1186/s12933-020-01101-9
What was done
A systematic review and meta-analysis of randomized controlled trials searched Medline, Embase, and Cochrane Central through March 3, 2020. The authors evaluated bempedoic acid versus placebo or no treatment for primary prevention of cardiovascular events in statin-intolerant patients with hypercholesterolemia. Primary outcomes were major adverse cardiac events and percent change in LDL-C; secondary outcomes included CRP levels and rates of new-onset or worsening diabetes.
What was found
Across 11 trials with 4,391 participants: - Composite cardiovascular outcome: significantly reduced with bempedoic acid (RR 0.75, 95% CI 0.56 to 0.99; I² = 0%). - LDL-C levels: significantly reduced (MD -22.91, 95% CI -27.35 to -18.47; I² = 99%). - CRP levels: significantly reduced (MD -24.70, 95% CI -32.10 to -17.30; I² = 53%). - New-onset or worsening diabetes: significantly reduced (RR 0.65, 95% CI 0.44 to 0.96; I² = 23%).
Why it matters
This meta-analysis synthesizes early randomized trial evidence showing that bempedoic acid effectively lowers lipid and inflammatory markers while potentially reducing composite cardiovascular events and diabetes incidence in statin-intolerant individuals.
Limits
The abstract lacks details on specific non-glycemic adverse events or discontinuation rates. There was extreme statistical heterogeneity for LDL-C reduction (I² = 99%) and moderate heterogeneity for CRP reduction (I² = 53%). Follow-up duration across trials is not specified in the abstract.
Cited by
- supports Bempedoic acid does not increase the risk of developing type 2 diabetes.