Cardiovascular and lipid experts don’t talk about this enough… for many years we’ve had several drugs that lower cholesterol or triglycerides but don’t improve morbidity or mortality (heart attacks, coronary artery stents, coronary artery bypass, or stroke numbers).
Statins lower LDL cholesterol and raise HDL cholesterol and show improvements in cardiovascular morbidity and mortality.
This is a statement from the product insert for bempedoic acid:
INDICATION AND IMPORTANT SAFETY INFORMATION
INDICATION
NEXLETOL and NEXLIZET are indicated as adjuncts to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.
Limitations of Use:
The effect of NEXLETOL and NEXLIZET on cardiovascular morbidity and mortality has not been determined
So if a drug manufacturer added a new cholesterol lowering compound to some small level of tolerable statin, then if researchers ever see any positive effects on morbidity or mortality, some of it may be from the statin.
You can see that they have another drug , Zetia/ ezetimibe, which is combined with the new bempedoic acid (Nexlizit).
Well, it turns out that the Zetia is also an add-on drug to statins. Zetia was introduced 20 years ago, also for people who don’t tolerate statins.
Zetia, by itself, does not reduce cardiovascular morbidity or mortality.
Zetia has been cheap for years because it’s a generic… generic drug plus a new, name brand drug, equals a very expensive, combination, pill.
I am very eager to see improvements in morbidity and mortality numbers for this new bempedoic acid.
Charles Tadros, MD
March 6, 2023
Saint Louis, Missouri