STATIN ALTERNATIVE SEES FEWER SIDE EFFECTS

Millions of Americans who are at high risk for heart attacks and whose LDL cholesterol levels are disturbingly high have been told over and over again by their doctors to take a statin. These cheap generic drugs have been shown repeatedly to slash cholesterol levels and prevent heart attacks, strokes and deaths. But many people cannot or will not take the drugs, often reporting that statins make their muscles ache.

Now, a study with 14,000 patients of a drug that lowers LDL levels and was designed to avoid muscle aches was found to modestly reduce the risk of heart attacks, strokes and other complications from heart disease.

It was published Saturday in The New England Journal of Medicine and presented at the annual meeting of the American College of Cardiology. The medication joins several statin alternatives that have been shown to reduce cardiac illnesses, but some experts say they doubt the drug is any more likely to be embraced by patients who are wary of statins and, often, other Ldl-lowering drugs.

The drug, bempedoic acid, is not new; the Food and Drug Administration approved it three years ago because it lowers LDL levels.

But the new study showed that bempedoic acid modestly decreased the combined risk of cardiovascular complications — heart attacks, strokes, blocked arteries that needed to be reopened with stents or bypass surgery, or cardiovascular death — although it did not decrease the overall mortality rate.

The trial was directed by Dr. Steven Nissen of the Cleveland Clinic and was paid for by the drug’s maker, Esperion Therapeutics, which sells it under the brand name Nexletol. It involved people who were at high risk for a heart attack or stroke and who were randomly assigned to take bempedoic acid or a placebo. Their average LDL level was high: 139 milligrams per deciliter. Cardiologists generally say such patients should get their LDL below 70.

Bempedoic acid reduced LDL levels by about 20 percent, not enough to get patients to the goal level. At the end of the study, the average LDL level in those taking the drug was 107, compared with 136 in the patients taking a placebo. In contrast, statins can reduce LDL levels by as much as 50 percent.