Pittsburgh Post-Gazette

FDA OKs first non-statin pill to treat high cholestero­l in almost two decades

- By Laurie McGinley

WASHINGTON — The FDA on Friday approved the first non-statin oral medication for high cholestero­l in almost two decades, giving patients and doctors another weapon against heart disease, the No. 1 killer in the United States and around the world.

The drug, bempedoic acid, is the first in a new class of drugs to treat lowdensity-lipoprotei­n cholestero­l, also called “bad” cholestero­l, which causes the buildup of fatty deposits in the arteries, reducing blood and oxygen flow.

Cardiologi­sts said the new drug, which is taken as a pill once a day, will be used primarily as an addon therapy for people who are taking as high a dose of statin medication­s as they can tolerate but still have higher-than-desired cholestero­l. Studies showed that bempedoic acid reduced cholestero­l by an average of 18% in patients taking moderate- or highdose statins, compared to the placebo group, said the manufactur­er, Esperion Therapeuti­cs Inc.

The medicine also can be used for patients who can tolerate only low-dose statins or can’t take statins at all. In studies involving those patients, it reduced LDL cholestero­l by 28%, the company said.

Esperion, which is based in Ann Arbor, Mich., said the drug’s brand name will be Nexletol. Esperion also has applied to the FDA for approval of a combinatio­n pill of bempedoic acid and ezetimibe, a non-statin pill approved in 2002. In studies, the combinatio­n pill reduced cholestero­l by about 38% to 44%, depending on whether a person was taking a statin and how much, the company said.

The FDA decision is expected shortly.

Statins, which were introduced in the 1980s, are the premier medicines for high cholestero­l and typically are the first drugs prescribed along with changes in diet and exercise.

The FDA approved bempedoic acid based on its cholestero­l-lowering effect. Whether the drug reduces the risk of heart attacks and strokes is being studied as part of a large outcomes trial involving people who can’t tolerate the side effects of statins.

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