When the body has an excessive amount of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, it can accumulate in the arteries and cause heart attacks or strokes.
Statins, such as Lipitor and Crestor, or their less expensive generic versions, are the go-to option for reducing LDL cholesterol levels and preventing heart disease.
These drugs operate by inhibiting the liver’s cholesterol synthesis.
Despite the effectiveness of statins in treating high cholesterol, some individuals experience severe muscle pain as a side effect. While the exact frequency of this occurrence remains unclear, some estimates suggest that 10% of those who are eligible for statin treatment either refuse or are unable to take the medication.
These individuals have few alternatives available to them, including expensive cholesterol-reducing injections or an alternative medication known as Zetia.
However, a recent significant study has shown that a different type of cholesterol-lowering drug called Nexletol can reduce the risk of heart attacks and other cardiovascular issues in individuals who are unable to tolerate statins, according to researchers who reported their findings on Saturday.
Several high-risk patients are already prescribed the medicine, chemically known as bempedoic acid, in conjunction with a statin to further reduce their cholesterol levels.
This new trial is the first to evaluate Nexletol independently of statins, and it provides the first indication that Nexletol may lower the risk of health issues brought on by high cholesterol.
Statins are still “the cornerstone of cholesterol-lowering therapy,” said the study’s principal investigator, Dr. Steven Nissen of the Cleveland Clinic.
But he said that people who can’t take these proven pills are “very needy patients” who are hard to treat. This choice “will significantly affect public health.”
Nexletol inhibits the liver’s ability to produce cholesterol in a similar manner as statins, but without the muscular adverse effect.
The new five-year study looked at the health of nearly 14,000 people who couldn’t take more than a very low dose of a statin. Half of the patients received daily Nexletol, while the other half received a placebo.
The most important result was that individuals given Nexletol had a 13% reduced incidence of many serious heart issues. Then, they disentangled the effects of each condition and discovered a 23% reduction in heart attack risk. Also, the medicine reduced by 19% the number of surgeries required to unblock arteries. Researchers were unable to determine why there was no change in fatalities, although they speculated that it could take more time to see.
On Saturday, researchers presented their findings at a conference of the American College of Cardiology, and the following day, the findings were published in the New England Journal of Medicine. Esperion Therapeutics, the company that makes Nexletol, financed the research.
Dr. John H. Alexander of Duke University, who was not involved in the research, called the findings “compelling” in the journal. They “will and should” encourage patients who are unable or unwilling to take statins to take the therapy.
Nevertheless, he warned that it is too soon to accept bempedoic acid as a replacement for statins. “It is premature,” he said. Statins are still the best choice for most patients because there is so much evidence that they are good for the arteries.
Image Credit: BEN STANSALL/AFP via Getty Images