The first-choice medication for treating high cholesterol is a class of drugs known as statins, but there may be an alternative for the millions of individuals who cannot or will not take such medications due to the adverse effects.
In a significant trial, researchers found that a different type of cholesterol-lowering medication called Nexletol decreased the incidence of heart attacks and a few other cardiovascular issues in those who can’t handle statins.
To help certain high-risk patients further drop their cholesterol, doctors already prescribe the medication, also known chemically as bempedoic acid, to be used with a statin.
The new study evaluated Nexletol without the statin combination and provides the first proof that it also lowers the risk of health issues brought on by high cholesterol.
Statins are still “the cornerstone of cholesterol-lowering therapy,” emphasized the study’s principal investigator, Dr. Steven Nissen of the Cleveland Clinic.
However, those who cannot take these well-proven medications “are highly needy patients, and they’re quite difficult to treat,” he claimed. This choice “will significantly affect public health.”
Heart attacks and strokes can result from too much LDL or “bad” cholesterol, which can clog arteries.
The mainstay for decreasing LDL cholesterol and preventing or treating heart disease are statin medications like Lipitor and Crestor or their affordable generic alternatives. They function by preventing a portion of the liver’s creation of cholesterol.
However, taking statins might cause severe muscle pain in some people. While it’s unclear how frequently that happens, some estimates place the number at 10% of those who would generally be eligible for the medications but are unable or unwilling to take them.
There are few options available to them, including costly cholesterol-lowering injections and another type of drug marketed as Zetia.
Nexletol inhibits the liver’s ability to produce cholesterol similarly to statins, but without the muscular adverse effect.
Around 14,000 participants who could only tolerate a modest statin dose were followed throughout the new five-year research.
Half of the patients received daily Nexletol, and the other half received a placebo.
The main finding was that patients on nexletol had a 13% decreased risk of developing a variety of serious cardiac issues.
According to the researchers’ analysis of those various illnesses, a 23% lower chance of a heart attack was the most significant effect.
The medication also reduced artery-clearing processes by 19%. Death rates were the same, which researchers couldn’t explain but suggested would take longer to notice.
The information was presented on Saturday at an American College of Cardiology meeting and was published in the New England Journal of Medicine. Esperion Therapeutics, the company that makes Nexletol, funded the study.
Dr. John H. Alexander of Duke University, who was not involved in the study, called the findings “compelling” in the journal. They “will and should” encourage patients unable or unwilling to take statins to use the medication.
However, he added that it was early to think of bempedoic acid as a substitute for statins. With the overwhelming evidence of vascular advantages, statins continue to be the medication of choice for most patients.