What Is the Purpose of These New Cholesterol Pills?
Over the past few decades, medications for high cholesterol have been at the forefront of cardiovascular disease treatment. Statins have long been the go-to therapy for lowering low-density lipoprotein (LDL) cholesterol—often called “bad cholesterol.”
Now, a new cholesterol lowering drug called bempedoic acid is gaining attention as a promising option, especially for patients who either cannot tolerate statins due to muscle pain or who need additional help to lower cholesterol to a healthy level.
How Does Bempedoic Acid Work?
Unlike LDL-targeting statins that act throughout the body, bempedoic acid works in the liver only. This new pill targets an enzyme involved in cholesterol production, reducing LDL levels without the muscle-related side effects seen in some statin users. It blocks the enzyme ATP citrate lyase, which is upstream of the enzyme targeted by statins.
This localized effect means:
- Less muscle exposure to the drug
- Lower likelihood of muscle pain or weakness
- Potential compatibility with statins or other lipid-lowering drugs
What Did the New Study Reveal About Its Effectiveness?
A major clinical trial called CLEAR Outcomes, published in the New England Journal of Medicine, studied over 13,000 patients who were at high risk for cardiovascular disease and unable to tolerate statins.
Here’s what researchers found:
- Bempedoic acid lowered LDL cholesterol levels by about 21% compared to placebo.
- It reduced the risk of major cardiovascular events, such as heart attack and stroke.
- The pill also showed modest improvements in reducing death from cardiovascular causes.
While these results are not revolutionary, they offer a valuable alternative for people who can’t take statins. The risk of heart attack, stroke, and other cardiovascular events declined noticeably in the group taking the new medicine.
How Does It Compare to Statins?
Statins remain the gold standard for lowering cholesterol. They can reduce LDL levels by up to 50% in some patients. However, side effects like muscle pain or liver enzyme elevation discourage many from continuing treatment.
Here’s how the two compare:
| Feature | Statins | Bempedoic Acid |
| Mechanism | Blocks HMG-CoA reductase | Blocks ATP citrate lyase |
| Target | Works throughout the body | Liver-specific |
| LDL Reduction | 30–50% | ~20% |
| Muscle Side Effects | Common | Rare |
| Used With Statins | Yes | Yes, or alone |
Who Should Consider Taking the New Pill?
Doctors say bempedoic acid is most suitable for:
- Patients with high cholesterol who can’t tolerate statins
- Individuals with atherosclerotic cardiovascular disease who need further LDL reduction
- Patients whose LDL levels remain high despite diet and lifestyle changes
However, it’s not intended to replace statins entirely. For most patients, statins still offer the best LDL-lowering results with long-term data supporting reduced risk of heart disease and stroke.
What Are the Risks and Side Effects?
In the CLEAR Outcomes study, bempedoic acid was generally well tolerated. However, like any drug, it’s not without side effects:
- Slightly higher rates of gout, likely due to increased uric acid levels
- Possible elevated liver enzymes
- Rare instances of tendon rupture
Still, it showed a lower risk of muscle pain, which makes it attractive for those who can’t tolerate statins.
How Do These Pills Fit into Broader Public Health Goals?
From a public health perspective, managing cholesterol is essential in reducing the global burden of cardiovascular disease. Many people don’t reach their target cholesterol levels with diet and lifestyle alone. Medications help bridge that gap.
The new pill could benefit:
- People genetically predisposed to high LDL levels
- Patients with diabetes, who are already at higher cardiovascular risk
- Older adults with existing heart disease or history of stroke
This medication offers a tailored therapy for patients who fall into treatment gaps—those who need help but can’t tolerate traditional statins.
What Role Do Diet and Lifestyle Still Play?
Even with the best cholesterol lowering pills, diet and exercise remain foundational to heart health. Doctors recommend:
- Reducing intake of saturated fats and trans fats
- Eating more fiber-rich foods like fruits, vegetables, and whole grains
- Staying active with regular aerobic exercise
- Avoiding smoking and excessive alcohol use
Pills like bempedoic acid are not substitutes for healthy habits but can help when those changes aren’t enough to lower cholesterol.
What Are Doctors Saying About This Medication?
The American College of Cardiology has welcomed the results of the CLEAR Outcomes trial, but with caution. Most doctors agree it’s a good option—not a replacement—for statins. They see the greatest benefit in:
- Patients with statin intolerance
- Those who haven’t reached LDL goals
- High-risk individuals who need additional cholesterol control
Doctors emphasize that managing LDL cholesterol is about layering treatments when needed, not always replacing one drug with another.
What Do Patients Need to Ask Their Doctors?
If you’re wondering whether this pill is right for you, ask your doctor the following:
- What are my current cholesterol numbers?
- Am I considered high risk for cardiovascular disease?
- Have I experienced side effects from taking statins?
- What are my LDL levels, and how far are they from the recommended range?
- Would this new cholesterol lowering drug be safe with my existing medications?
- Are there other non-statin treatments I should consider?
The decision to use bempedoic acid is a personalized one, best made with your healthcare provider.
Is There a Cost or Accessibility Concern?
New medications can be expensive. Bempedoic acid is still under brand-name protection, and insurance coverage may vary. It’s important to:
- Check your health insurance formulary
- Inquire about generic or combination options
- Ask about patient savings programs
More research and FDA approvals may help bring down costs over time.
What Does the Future Hold for Cholesterol Treatment?
The future of cholesterol therapy looks promising, with innovations focusing on:
- Genetic treatments to modify lipoprotein production
- Monoclonal antibodies to reduce LDL cholesterol dramatically
- Combination therapies using statins, ezetimibe, and now bempedoic acid
New findings suggest we’re moving toward personalized therapy based on genetics, existing health conditions, and medication tolerance.
What Should You Remember Most?
If you or someone you love has high cholesterol or a history of heart disease, it’s important to know:
- New study shows bempedoic acid helps lower LDL cholesterol and reduce the risk of heart attack or stroke.
- This cholesterol lowering drug works well for patients who experience muscle pain with statins.
- It’s not a cure-all, but it is a helpful option in a growing toolbox.
- Lifestyle, diet, and regular checkups remain essential.
You can always reach out to Avicenna Cardiology if you’re in New York and want personalized care focused on heart health. They offer evaluations and treatment plans based on the latest research.
Works Cited
“A Pill That Cuts Cholesterol Without Muscle Pain? Here’s What We Know.” Times of India, 2024, https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/now-a-cholesterol-pill-to-cut-down-the-risk-of-a-heart-attack-new-study-reveals-hopeful-results/articleshow/121880151.cms.
Gormley, Brian. “New Cholesterol Drugs Show Hope in Reducing Heart Attacks.” Barron’s, 1 Mar. 2024, https://www.barrons.com/articles/strokes-heart-attacks-cholesterol-drugs-stocks-d9b3230e.
Nissen, Steven E., et al. “Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients.” New England Journal of Medicine, vol. 388, 2023, pp. 1353–1364.
“Bempedoic Acid: A New Option for Cholesterol Management.” American College of Cardiology, 2023, https://www.acc.org/Latest-in-Cardiology/Articles/2023/03/01/08/00/Bempedoic-Acid-and-CVD-Outcomes.
“High Cholesterol: Prevention and Treatment.” Centers for Disease Control and Prevention (CDC), 2023, https://www.cdc.gov/cholesterol/prevention-treatment.htm.
Frequently Asked Questions (FAQ)
2. Does bempedoic acid really prevent heart attacks?
Yes, a recent clinical trial published in the New England Journal of Medicine showed that bempedoic acid reduced LDL cholesterol levels by about 21% and led to fewer cardiovascular events, including heart attacks and strokes, in patients at high risk of cardiovascular disease.
3. Who should consider taking this new pill?
It’s most suitable for people who:
- Have high cholesterol but can’t tolerate statins
- Still have elevated LDL levels despite diet and lifestyle changes
- Are at high risk for atherosclerotic cardiovascular disease and need additional cholesterol lowering therapy
Always consult with a doctor to assess whether this treatment is right for you.
4. Are there any side effects to be aware of?
Yes. While bempedoic acid is generally well-tolerated, some reported side effects include:
- Increased risk of gout
- Slight elevation in liver enzymes
- Rare cases of tendon rupture
However, it causes less muscle pain than statins and is often safer for those who can’t use traditional therapies.
5. Can bempedoic acid replace healthy lifestyle changes?
No. While the pill helps lower cholesterol, it’s not a substitute for healthy habits. A balanced diet, regular exercise, and avoiding smoking and excessive alcohol are still essential for reducing the risk of heart disease and supporting overall public health.
