# Bempedoic acid Drug · id `cardio:bempedoic-acid` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Nexletol Browse, condition area: Coronary and vascular disease ## In plain language Bempedoic acid is a daily pill that lowers LDL cholesterol. In CLEAR Outcomes, which enrolled people who could not take statins, it lowered a combined set of heart events in statin-intolerant people, but it did not show an effect on death. ## Technical summary RxNorm ingredient 2282403. The CLEAR Outcomes abstract describes it as an ATP citrate lyase inhibitor. Outcomes evidence: CLEAR Outcomes (statin-intolerant people only). ## Claims, with the population each applies to ## Context: Statin-intolerant adults with or at high risk for cardiovascular disease (CLEAR Outcomes) Recipient: Adult; Population: Patients unable or unwilling to take statins because of unacceptable adverse effects (statin-intolerant) who had, or were at high risk for, cardiovascular disease (abstract). The registry gives ages 18 to 85 years.; Care setting: Multicentre trial (abstract); site list not read; Geography: Multinational: the study record lists every country the registry names; Life stage: Adult, 18 to 85 years (registry); Follow-up: Median follow-up 40.6 months (abstract). ### In CLEAR Outcomes, 13,970 statin-intolerant patients who had, or were at high risk for, cardiovascular disease took bempedoic acid 180 mg daily (6992) or placebo (6978). Over a median of 40.6 months, the four-component primary composite occurred in 819 patients (11.7%) on bempedoic acid and 927 (13.3%) on placebo (hazard ratio 0.87, 95% CI 0.79 to 0.96). The abstract says there were no significant effects on fatal or nonfatal stroke, death from cardiovascular causes, or death from any cause. Gout (3.1% against 2.1%) and cholelithiasis (2.2% against 1.2%) were more common with bempedoic acid, as were small increases in serum creatinine, uric acid and hepatic-enzyme levels. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Patients unable or unwilling to take statins because of unacceptable adverse effects (statin-intolerant) who had, or were at high risk for, cardiovascular disease (abstract). The registry gives ages 18 to 85 years.; Care setting: Multicentre trial (abstract); site list not read; Geography: Multinational: the study record lists every country the registry names; Life stage: Adult, 18 to 85 years (registry); Follow-up: Median follow-up 40.6 months (abstract). - Limitations: One randomised, double-blind trial funded by Esperion Therapeutics according to the abstract. The primary composite includes coronary revascularization, which is a softer end point than death. The result is for statin-intolerant people and does not apply to people who tolerate statins. Abstract only. - Last checked: 2026-10-14 - Sources: 1. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1: "A total of 13,970 patients underwent randomization; 6992 were assigned to the bempedoic acid group and 6978 to the placebo group.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Abstract of the paper from PubMed; the full text was not read. 2. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1, fragment 1 of 2: "We conducted a double-blind, randomized, placebo-controlled trial involving patients who were unable or unwilling to take statins owing to unacceptable adverse effects ("statin-intolerant" patients)". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Statin-intolerant population. 3. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1, fragment 2 of 2: "and had, or were at high risk for, cardiovascular disease.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: With, or at high risk for, cardiovascular disease. 4. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 2: "The patients were assigned to receive oral bempedoic acid, 180 mg daily, or placebo.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Dose and comparator. 5. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2: "The median duration of follow-up was 40.6 months.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Median follow-up. 6. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 1 of 5: "The incidence of a primary end-point event was significantly lower with bempedoic acid than with placebo (819 patients \[11.7%\] vs. 927 \[13.3%\]; hazard ratio,". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Primary end point counts. 7. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 2 of 5: "0.87; 95% confidence interval \[CI\], 0.79 to 0.96; P = 0.004), as were the incidences of a composite of death from cardiovascular causes,". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Primary end point counts and hazard ratio. 8. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 5: "Bempedoic acid had no significant effects on fatal or nonfatal stroke, death from cardiovascular causes, and death from any cause.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Stroke and death results, as reported. 9. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 6, fragment 1 of 2: "The incidences of gout and cholelithiasis were higher with bempedoic acid than with placebo (3.1% vs. 2.1% and 2.2% vs. 1.2%, respectively),". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Gout and cholelithiasis. 10. Supports: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 6, fragment 2 of 2: "as were the incidences of small increases in serum creatinine, uric acid, and hepatic-enzyme levels.". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Laboratory changes. 11. Background: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 2: "(Funded by Esperion Therapeutics; CLEAR Outcomes ClinicalTrials.gov number, NCT02993406.).". Retrieved 2026-10-14T18:18:35Z. Source state: Current. Snapshot hash: eb061946988abbdd8b8981c59570bfa5922d46a4046867ca220ccf6623009af5. How it applies: Funding note in the abstract. ## Connected pages - Fewer major cardiovascular events in statin-intolerant people: High LDL cholesterol (`cardio:high-ldl-cholesterol`) [a claim, not a settled fact; see claim `cardio:claim-clear-outcomes-bempedoic-acid` and its context] - Files under this front: Medicines (`cardio:front-medicines`) - Investigated in: CLEAR Outcomes (bempedoic acid in statin-intolerant people) (`cardio:clear-outcomes`) ## Provenance Content hash: f1710e1cafdbfc8beea3064794dd7e3a046472caf054b4df9a5b937d2d111e7f Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14