by Maria Gorla, Doctor of Pharmacy Candidate and Daniel M. Riche PharmD, BCPS, AHA-CHC, CLS, University of Mississippi School of Pharmacy

It is well established that elevated low-density lipoprotein cholesterol (LDL-C) is directly associated with the development of atherosclerotic cardiovascular disease (ASCVD). More than 70 million adults in the United States have elevated LDL-C, yet less than half receive treatment, and only a third reach the desired LDL-C target.1 Statin therapy is the cornerstone of pharmacologic treatment for hypercholesterolemia; however, some patients are unable to tolerate statin therapy, and not all who tolerate statin therapy achieve lipid goals with statins alone. In patients with clinical ASCVD, it is recommended to reduce LDL-C to less than 70 mg/dL.2 If this target is not attainable with statins alone, additional agents should be employed to reduce the risk of recurrent ASCVD events. Furthermore, a combination of therapies is often needed to achieve appropriate LDL-C reduction in patients with familial hypercholesterolemia (FH). FH is a genetic condition that results in a defective LDL receptor and prevents the efficient removal of LDL cholesterol from the bloodstream. Patients with FH generally have LDL >190 mg/dL, which places them at a much higher risk for developing ASCVD. FH accelerates the risk of coronary heart disease by 10 to 20 years in men and by 20 to 30 years in women.3 Patients with FH or those with clinical ASCVD on maximally tolerated statin therapy often require additional lipid-lowering therapies, and bempedoic acid is a new treatment option for these patients.

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References

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  9. Nexletol [package insert]. Ann Arbor, MI: Esperion Therapeutics, INC; 2020
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