Which statement about ACL inhibitors (bempedoic acid) is true?

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Multiple Choice

Which statement about ACL inhibitors (bempedoic acid) is true?

Blocking ATP-citrate lyase stops a key early step in hepatic cholesterol synthesis, reducing the acetyl-CoA pool available for making cholesterol. With less cholesterol in the liver, LDL receptors are upregulated, pulling more LDL-C out of the blood and lowering LDL levels. Bempedoic acid is activated mainly in the liver, which helps limit muscle-related side effects often seen with other lipid-lowering therapies. This mechanism is distinct from increasing HMG-CoA reductase activity, which would raise cholesterol synthesis; from directly inhibiting intestinal cholesterol absorption, which is ezetimibe’s job; and from increasing HDL-C by activating PPAR-alpha, which is a feature of fibrates.

Blocking ATP-citrate lyase stops a key early step in hepatic cholesterol synthesis, reducing the acetyl-CoA pool available for making cholesterol. With less cholesterol in the liver, LDL receptors are upregulated, pulling more LDL-C out of the blood and lowering LDL levels. Bempedoic acid is activated mainly in the liver, which helps limit muscle-related side effects often seen with other lipid-lowering therapies. This mechanism is distinct from increasing HMG-CoA reductase activity, which would raise cholesterol synthesis; from directly inhibiting intestinal cholesterol absorption, which is ezetimibe’s job; and from increasing HDL-C by activating PPAR-alpha, which is a feature of fibrates.

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