Nexletol (bempedoic acid) / Esperion Therap, Otsuka, Daiichi Sankyo, NeoPharm, HLS Therap, CSL Behring - LARVOL DELTA

The 2025 ESC/EAS Dyslipidaemia Focused Update: Clinical Interpretation and Practical Implications. (PubMed, Cardiovasc Drugs Ther) - "New evidence supporting bempedoic acid, inclisiran and evinacumab expands the therapeutic armamentarium, particularly for patients at high, very high and extreme cardiovascular risk or those with statin intolerance. In the acute coronary syndrome (ACS) setting, the update reinforces a more proactive, early-intensification approach. Overall, the Focused Update refines the operational framework of LDL-C management, promoting earlier, more personalized and more sustained lipid lowering to reduce cumulative atherosclerotic exposure."

Journal • Review • Acute Coronary Syndrome • Atherosclerosis • Cardiovascular • Dyslipidemia

Novel cholesterol lowering drugs: Can phase 2/3 clinical trial safety assessments predict cardiovascular event outcome trial efficacy? (PubMed, Am Heart J Plus) - "Seven drugs were reviewed in 3 cholesterol-lowering classes: CETP inhibitors, bempedoic acid, and PCSK9 inhibitors...One drug (dalcetrapib) had a trend for benefit observed, albeit with very small numbers, in early development, but showed a neutral CVOT. There was a moderate correlation between the risk reductions or increases from the non-CVOTs and CVOTs: r = 0.69, p = 0.0893. Within the limitations of the drugs studied and the variability in MACE definitions, there is value in the results of non-CVOTs to predict the CVOT outcome."

Journal • P2/3 data • Atherosclerosis • Cardiovascular

In silico prediction of the lipid-lowering efficacy of the oral PCSK9 inhibitor enlicitide using a mechanistic computational model. (PubMed, Atherosclerosis) - P3 | "This first successful prospective validation of our mechanistic QSP model against a large cardiovascular phase 3 trial, confirms the model's credibility. It supports the contribution of in silico trials to accelerate the development and evaluation of innovative lipid-lowering therapies to improve cardiovascular outcomes."

Journal • Atherosclerosis • Cardiovascular

From physiopathology to treatment of familial hypercholesterolemia: Existing and emerging pharmacotherapies. (PubMed, Pharmacol Rev) - "This includes established drugs such as proprotein convertase subtilisin/kexin type 9 inhibitors, inclisiran, lomitapide, and bempedoic acid. Emerging therapies include evinacumab, lerodalcibep, antisense oligonucleotide-based drugs, certain cholesteryl ester transfer protein inhibitors like obicetrapib, AZD8233, gemcabene, diacylglycerol O-acyltransferase-2 inhibitors, acyl-CoA:cholesterol acyltransferase-2 inhibitors, vupanorsen, volanesorsen, olezarsen, pelacarsen (TQJ230), olpasiran (AMG890), zerlasiran (SLN360), lepodisiran (LY3819469), and muvalaplin...Recent pharmacological advancements provide significant opportunities for successful low-density lipoprotein cholesterol management and control of FH. Although some of these agents are already used, several highly effective compounds are in development, heralding a promising future for FH treatment."

Journal • Review • Atherosclerosis • Cardiovascular • Dyslipidemia • Familial Hypercholesterolemia • Genetic Disorders • Metabolic Disorders • APOB

Adjunctive pharmacological strategies for residual risk reduction after myocardial revascularisation. (PubMed, EuroIntervention) - "The introduction of ezetimibe, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 inhibitors have further strengthened the effectiveness of LDL cholesterol management, particularly in patients who are statin intolerant or who remain at high risk despite maximal tolerated statin therapy...Clinical trials examining anti-inflammatory therapies, such as colchicine and interleukin-1β inhibitors (e.g., canakinumab), have demonstrated beneficial effects in reducing cardiovascular events independent of lipid modification. This narrative review provides an updated overview targeted specifically at physicians performing coronary artery bypass grafting or percutaneous coronary intervention. It summarises current evidence regarding established lipid-lowering therapies, emerging therapeutic approaches to address residual lipid risk, and the evolving role of anti-inflammatory interventions in the comprehensive management of ASCVD."

Journal • Review • Atherosclerosis • Cardiovascular • Dyslipidemia • Inflammation • IL1B

The High Price of Interrupted Follow-Up: Catastrophic Progression of Homozygous Familial Hypercholesterolemia-A Case Report and Literature Review. (PubMed, Clin Case Rep) - "Despite treatment with atorvastatin and evolocumab, partial lipid control was achieved, and follow-up was disrupted during the COVID-19 pandemic...Coronary angiography demonstrated critical coronary stenoses, while subsequent adjustments in her lipid-lowering regimen, including rosuvastatin, ezetimibe, increased evolocumab dosing, and bempedoic acid, failed to stabilize her condition...Early detection and sustained, multidisciplinary management are essential to mitigate rapid cardiovascular deterioration in HoFH patients. Consistent monitoring and prompt therapeutic adjustments remain pivotal in improving outcomes and reducing the high mortality risk associated with advanced aortic and coronary complications in these patients."

Journal • Atherosclerosis • Cardiovascular • Congestive Heart Failure • Dyslipidemia • Familial Hypercholesterolemia • Genetic Disorders • Heart Failure • Homozygous Familial Hypercholesterolemia • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease • Pulmonary Disease • APOB • LDLR • PCSK9

Effect of bempedoic acid on cardiovascular risk in patients with metabolic dysfunction-associated steatotic liver disease. (PubMed, Eur J Prev Cardiol) - "Liver steatosis and fibrosis assessed with non-invasive tests are associated with an increased risk of MACE4. Bempedoic acid reduced MACE4 risk, with an additional benefit in patients with elevated steatosis scores."

Journal • Cardiovascular • Fibrosis • Hepatology • Immunology • Liver Cirrhosis • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease

Helper-dependent adenoviral vector-mediated expression of an LDL receptor/transferrin chimeric protein in muscle safely reduces atherosclerosis in LDLR-deficient mice. (PubMed, Mol Ther) - "Treatments, including statins, ezetimibe, and PCSK9 inhibitors, and bempedoic acid, are often insufficient in homozygous FH patients, particularly those with null mutations in the LDL receptor. A single intramuscular administration of the HD-Ad vector induced expression of the murine fusion protein led to a twelve-month improving the lipid profile with a reduction of aortic atherosclerosis in LDLR-deficient mice. Furthermore, we observe no major systemic toxicity indicating that the present strategy may represent more effective therapy for FH patients."

Journal • Preclinical • Atherosclerosis • Cardiovascular • Dyslipidemia • Familial Hypercholesterolemia • Genetic Disorders • Homozygous Familial Hypercholesterolemia • Metabolic Disorders

Differential musculoskeletal outcome reporting in patients receiving bempedoic acid or atorvastatin: a disproportionality analysis using the EudraVigilance database. (PubMed, Front Pharmacol) - "Using a Registry-based approach, we found increased odds of muscle-related ADR reports in BA recipients compared to ATO, although characterized by more favourable clinical outcomes. It is suggested to pay increased attention to consider drug-related causes of muscle symptoms when BA is used, particularly when in combination with statins."

Journal • Atherosclerosis • Cardiovascular • Dyslipidemia • Musculoskeletal Diseases

Impact of conventional lipid-lowering therapy on circulating levels of proprotein convertase subtilisin/kexin type 9: A systematic review and meta-analysis of randomised controlled trials. (PubMed, Diabetes Obes Metab) - "Conventional lipid-lowering agents, such as statins, ezetimibe, fibrates, bile acid sequestrants, nicotinic acid, bempedoic acid, and omega-3, play a pivotal role in managing dyslipidemia. These findings highlight the necessity for clinicians to monitor PCSK9 concentrations in patients undergoing lipid-lowering treatment to optimise therapeutic strategies and mitigate associated cardiovascular risks. Our study contributes to a nuanced understanding of the biochemical effects of lipid-lowering therapies, potentially guiding future clinical practices and research in cardiovascular risk management."

Journal • Retrospective data • Review • Cardiovascular • Dyslipidemia • Metabolic Disorders

REGIONAL COMPARISON OF MEDICARE COVERAGE AND RESTRICTION OF ALIROCUMAB, EVOLOCUMAB, AND BEMPEDOIC ACID (ACC 2026) - "Abstract is embargoed at this time."

Medicare • Reimbursement • US reimbursement • Cardiovascular

Clinician-level variation in lipid management for secondary prevention of atherosclerotic cardiovascular disease: Opportunities for practice improvement. (PubMed, Am J Prev Cardiol) - "Among 9098 patients with ASCVD (median age 71.0 years, 61.6% male, 70.5% White) seen across 77 cardiology clinicians (56 physicians, 21 APPs), 52.8% were on a high-intensity statin, 17.1% were on ezetimibe, 7.8% were on novel LLT (proprotein convertase subtilisin/kexin type 9 monoclonal antibody, inclisiran, or bempedoic acid). Even among cardiology clinicians at the same academic medical center, practice patterns varied widely in using LLT and achieving LDL-C goals for secondary prevention. Understanding the reasons for this variability and standardizing lipid management across the specialty may improve quality of care for patients with ASCVD."

Journal • Atherosclerosis • Cardiovascular • CNS Disorders • Coronary Artery Disease • Diabetes • Dyslipidemia • Metabolic Disorders • Peripheral Arterial Disease • Vascular Neurology

Seventeen years to change practice: will the 2025 ESC/EAS dyslipidaemia guidelines finally break the Sisyphean cycle? (PubMed, Atherosclerosis) - "The extension of the pharmacological arsenal of lipid-lowering therapies with bempedoic acid, evinacumab, inclisiran, icosapent ethyl (and not mixtures with of eicosapentaenoic acid and docosahexaenoic acid) have enriched the arsenal of LDL-cholesterol and triglyceride-lowering drugs...Therefore, the guidelines recommend immediate initiation of high-intensity statin with ezetimibe for most patients with acute coronary syndrome or the immediate intensification of the therapy in those who are already on lipid-lowering drugs at the acute event...This update also has weaknesses, including missed opportunities to promote a more courageous approach for combination therapies, limitations in the diabetes risk classification, and discrepancies across ESC guideline papers which hopefully will be overcome in the next full update. Since real-world clinical adoption is far slower than evidence creation, implementation lags remain a Sisyphean obstacle, highlighting the ongoing need..."

Journal • Review • Acute Coronary Syndrome • Cardiovascular • Diabetes • Dyslipidemia • Metabolic Disorders

Cardiology : new 2025 guidelines (PubMed, Rev Med Suisse) - "In the management of dyslipidemia, lipoprotein (a) measurement has become a key component of cardiovascular risk assessment, while bempedoic acid is emerging as an effective treatment option for statin-intolerant patients. The Pregnancy Heart Team now provides a structured care pathway for cardiac patients before, during, and after pregnancy. Prevention plays a crucial role, supported by the growing awareness of the close link between mental health and cardiovascular health."

Journal • Cardiovascular • Dyslipidemia • Metabolic Disorders

Efficacy And Safety Of Enlicitide Decanoate, An Oral Macrocyclic Peptide Inhibitor Of PCSK9, Compared With Bempedoic Acid, Ezetimibe, Or Bempedoic Acid Co-administered With Ezetimibe In Statin-treated Adults With Hypercholesterolemia: Phase 3 CORALreef AddOn Trial (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Late-breaking abstract • P3 data • Dyslipidemia • Metabolic Disorders

Clear Pathway: the role of bempedoic acid in lipid-lowering strategies. The opinion of cardiologists from Piedmont and Aosta Valley, Italy (PubMed, G Ital Cardiol (Rome)) - "The Clear Pathway recommendations outline a model for dyslipidemia management based on integrated oral therapies, with a key role for bempedoic acid. Adopting these guidelines is expected to improve adherence, optimize achievement of LDL-C targets, and reduce the incidence of cardiovascular events in routine clinical practice."

Journal • Acute Coronary Syndrome • Cardiovascular • Dyslipidemia • Metabolic Disorders

Progress in risk assessment and management: Forecasting updates across international cholesterol guidelines. (PubMed, Am J Prev Cardiol) - "For high-risk individuals, combination therapy with low/moderate intensity statin and ezetimibe or bempedoic acid should be considered. Among individuals treated with PSCK9i therapy, those with elevated Lp(a) may have greater ASCVD risk reduction and may be a patient population that is prioritized for PCSK9i until therapies directly targeting Lp(a) are available. An ASCVD risk-based approach should be the foundation for determining LDL-C goals with consideration that multiple lipid-lowering therapies are often necessary for high and very-high risk patients who were treated to very low LDL-C in more recent randomized controlled trials."

Journal • Review • Cardiovascular • Dyslipidemia • Metabolic Disorders

Musculoskeletal adverse events associated with bempedoic acid: a real-world pharmacovigilance study. (PubMed, J Cardiovasc Pharmacol) - "Elderly male patients were more likely to develop serious MAEs. Enhanced monitoring is recommended when administering bempedoic acid to high-risk populations."

Adverse events • Journal • Real-world evidence • Musculoskeletal Diseases • Musculoskeletal Pain • Pain

COMPARATIVE EFFICACY OF PCSK9 INHIBITORS VS BEMPEDOIC ACID AMONG PATIENTS WITH ASCVD WITHOUT DIABETES : A REAL WORLD ANALYSIS (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Real-world • Real-world evidence • Cardiovascular • Diabetes • Metabolic Disorders

BEMPENET: Multicenter Study on the Evaluation of Adherence, Persistence and Efficacy of Treatment With Bempedoic Acid in Italy (clinicaltrials.gov) - P=N/A | N=1500 | Recruiting | Sponsor: Federico II University

New trial • Dyslipidemia • Metabolic Disorders

BEMPEDOIC ACID AND CARDIOVASCULAR OUTCOMES IN PATIENTS WITH AUTOIMMUNE OR INFLAMMATORY DISEASES: AN ANALYSIS OF THE CLEAR OUTCOMES TRIAL (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular • Immunology • Inflammation

Bempedoic acid directly binds and activates PPARα. (PubMed, Cell Metab) - "Notably, BA-mediated induction of fatty acid oxidation required PPARα. Together, this work reveals direct PPARα activation as a key mechanism of BA action, providing a molecular basis for its lipid-lowering effects and suggesting broader therapeutic potential beyond the liver."

Journal • Cardiovascular • Metabolic Disorders • PPARA • SLC27A2

Low density lipoprotein target achivement in very high and extreme cardiovascular risk patients during a cardiac rehabilitation program. (PubMed, Nutr Metab Cardiovasc Dis) - "Our results are highly encouraging compared to those reported in previous observational studies. The further we move from guideline publication, the higher the proportion of patients achieving LDL targets, supported by increased clinical awareness and new pharmacological options. However, more attention should be paid to extreme CV risk patients, both in term of correct dentification and treatment."

Journal • Cardiovascular • Dyslipidemia

BEMPEDOIC ACID AND INCIDENCE OF STROKE AMONG STATIN-INTOLERANT PATIENTS: AN ANALYSIS OF THE CLEAR OUTCOMES TRIAL (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular

STATIN-ASSOCIATED AUTOIMMUNE MYOPATHY: SUCCESSFUL TREATMENT WITH BEMPEDOIC ACID (ACC 2026) - "Abstract is embargoed at this time."

Immunology • Myositis