{ "release_id": "5dcd9b263fe17744", "id": "cardio:bempedoic-acid", "owner": "cardio", "kind": "drug", "slug": "bempedoic-acid", "name": "Bempedoic acid", "aliases": [ "Nexletol" ], "atlases": [ "cardio" ], "summary_plain": "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.", "summary_technical": "RxNorm ingredient 2282403. The CLEAR Outcomes abstract describes it as an ATP citrate lyase inhibitor. Outcomes evidence: CLEAR Outcomes (statin-intolerant people only).", "editorial_state": "draft", "last_substantive_edit": "2026-10-14", "last_evidence_check": "2026-10-14", "next_review_due": null, "identifiers": [ { "scheme": "rxnorm", "value": "2282403", "normalized_value": "2282403", "match": "exact", "version": null, "label": null, "from_source": false } ], "navigation": { "cardio": { "condition-area": [ "coronary-and-vascular-disease" ] } }, "payload": { "level": "substance", "mechanism": "ATP citrate lyase inhibitor that reduces LDL cholesterol (CLEAR Outcomes abstract)" }, "content_digest": "f1710e1cafdbfc8beea3064794dd7e3a046472caf054b4df9a5b937d2d111e7f", "review": { "content_digest": "f1710e1cafdbfc8beea3064794dd7e3a046472caf054b4df9a5b937d2d111e7f", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-clear-outcomes-bempedoic-acid", "owner": "cardio", "subject_entity_id": "cardio:bempedoic-acid", "category": "effect", "statement": "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.", "context": { "id": "cardio:ctx-clear-statin-intolerant-adults-with-or-at-risk-of-cvd", "label": "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_note": "Adult, 18 to 85 years (registry)", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up 40.6 months (abstract).", "eligibility": { "inclusion": [ "Unable or unwilling to take statins owing to unacceptable adverse effects", "Had, or at high risk for, cardiovascular disease" ], "exclusion": [] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "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. 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