What is bempedoic acid and its place in therapy?

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Multiple Choice

What is bempedoic acid and its place in therapy?

Bempedoic acid lowers LDL-C by inhibiting ATP citrate lyase, an enzyme in hepatic cholesterol synthesis that is upstream of where statins act. Blocking ACL decreases hepatic cholesterol production, which in turn upregulates LDL receptors and increases clearance of LDL cholesterol from the blood. Because it is a liver-activated prodrug, its activity is focused in the liver, reducing muscle exposure and making it a useful option for patients who cannot tolerate statins. Clinically, it fits as add-on therapy or as monotherapy in statin-intolerant patients or when statins alone don’t achieve LDL-C goals, providing a meaningful additional reduction in LDL-C. It is not a fibrate, not a cholesterol absorption inhibitor, and not a PCSK9 inhibitor.

Bempedoic acid lowers LDL-C by inhibiting ATP citrate lyase, an enzyme in hepatic cholesterol synthesis that is upstream of where statins act. Blocking ACL decreases hepatic cholesterol production, which in turn upregulates LDL receptors and increases clearance of LDL cholesterol from the blood. Because it is a liver-activated prodrug, its activity is focused in the liver, reducing muscle exposure and making it a useful option for patients who cannot tolerate statins. Clinically, it fits as add-on therapy or as monotherapy in statin-intolerant patients or when statins alone don’t achieve LDL-C goals, providing a meaningful additional reduction in LDL-C. It is not a fibrate, not a cholesterol absorption inhibitor, and not a PCSK9 inhibitor.

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