Pill that is just as good as statins... without the side-effects

‘Could cut risk of heart attacks’

A NEW alternative to statins could help hundreds of thousands of patients ward off heart disease.

Research suggests that a drug called bempedoic acid is just as good as statins at lowering cholesterol – but without the same side-effects.

A trial led by Imperial College London shows the pills can be taken with statins for those who cannot get their cholesterol down to a safe level with the latter alone.

‘Bempedoic acid could be another addition to the arsenal of cholesterol-lowering treatments available to patients,’ said Kausik Ray, who led the study.

‘We have a new class of drug that could be given to patients who are already taking statins and could help them to further reduce their cholesterol levels and thus potentially cut their risk of heart attacks and strokes.’

Roughly six million Britons take statins, preventing 80,000 heart attacks and strokes every year at the cost of roughly £20 a year per patient. But many of those stop taking the drugs because of side- effects, with between 5 per cent and 20 per cent giving up because of muscle pain.

The only alternatives until now have been expensive injections called PCSK9-inhibitors. But the NHS barely uses them because they cost more than £4,000 a year.

Professor Ray believes bempedoic acid could provide an alternative treatment to those who cannot cope with the side-effects of statins but who do not qualify for expensive injections.

The drug has not yet been given a price but because it is a simple chemical – rather than the complex antibody used in PCSK9inhibitors – experts anticipate it will be much cheaper. It could also be used by the many people – including some who have already had a heart attack – who struggle to lower their cholesterol levels even using statins.

Professor Ray said: ‘I would have thought the number of people in Britain who might benefit would be in the hundreds of thousands.’

His trial of 2,200 patients, published last night in the prestigious New England Journal of Medicine, showed that when taken alongside statins, bempedoic acid reduced cholesterol levels by 18 per cent more than taking statins alone.

The drug company Esperion, which makes bempedoic acid, has already submitted an application for a licence to the European Medicines Agency.

If approved, it could be available by next year.

Like statins, bempedoic acid works by blocking a key enzyme called ATP-citrate lyase that is used by the body to make cholesterol, but in a slightly different way. The study showed the treatment was well tolerated by patients, with some increased incidence of gout – due to slight rises in the level of uric acid in their blood – but no higher incidence of serious health conditions.

Professor Ray added: ‘One of the key advantages of bempedoic acid is supposed to be that it shouldn’t cause the muscle side- effects reported by some statins users, as it taken up by the liver and needs to be converted into its active form via an enzyme only found in the liver.

‘Once converted to the active form the drug cannot leave the liver, so it can’t enter muscles and hence could be of considerable advantage for some.

‘ It could be an option for patients who are unable to tolerate statins at higher doses, or at all.’ In a second study, published in the same journal, the team looked at genetic data from more than half a million people to model the likely effects of the treatment in the long term. This study suggested that taken alone, bempedoic acid was just as good as statins at cutting the risk of heart disease.

Sir Nilesh Samani, of the British Heart Foundation, said ‘this new drug could provide real benefit’ for the few people who can’t take statins or require additional treatments. He added: ‘ The research suggests that it has the potential to reduce risk of heart attacks and strokes without major side-effects.’