Is Bempedoic Acid the CLEAR Answer to Statin Intolerance?

This transcript has been edited for clarity.

Michelle L. O'Donoghue, MD, MPH: Hi. This is Dr. Michelle O'Donoghue, reporting for Medscape. Joining me today is Ann Marie Navar, who is an associate professor of medicine at UT Southwestern and is ostensibly one of the world's experts on lipid-lowering therapies and thinking about which therapies to use. Ann Marie, thanks for joining me today.

Ann Marie Navar, MD, PhD: Oh, total pleasure, Michelle.

O'Donoghue: Some of the buzz at ACC 2023 is the CLEAR Outcomes trial and bempedoic acid. This is the first clinical outcomes trial we have on bempedoic acid. Do you want to talk about what makes bempedoic acid different than other lipid-lowering therapies and what you think about the study results?

What's Unique About Bempedoic Acid

Navar: The first thing that's important to point out is what makes it the same. Bempedoic acid does something that we know works to lower cardiovascular disease, which is to upregulate low-density lipoprotein cholesterol (LDL-C) receptors. It works in the same pathway as statins, but it works upstream from statins. So it's a little bit different mechanistically.

What makes bempedoic acid perhaps a little bit special compared with statins is that it's actually a prodrug and the enzyme that makes it active is not present in skeletal muscle, and there's a hypothesis that that may make it better tolerated in people than statins.