According to a study, bempedoic acid can reduce the requirement for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and serve as a less expensive option to proven oral lipid-lowering drugs in patients with full statin intolerance.
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Researchers determined the target populations for
bempedoic acid and PCSK9 inhibitors, as well as the associated treatment costs,
to attain an LDL-C objective of 55 mg/dL and a 50% reduction assuming the
addition of bempedoic acid to lipid-lowering drugs.
The study comprised 1,922 patients with coronary
artery disease (CAD) who were part of the INTERCATH observational cohort trial.
The researchers used a Monte Carlo simulation to see how adding a statin,
ezetimibe, optional bempedoic acid, and a PCSK9 inhibitor in that order might
affect achieving the LDL-C treatment objective. They created two scenarios:
with and without bempedoic acid, for both a moderate (2 percent full and 10%
partial) and a high (12 percent full) rate of statin intolerance.
The population's average age was 69.3 years, with a
median baseline LDL-C level of 86.0 mg/dL. A PCSK9 inhibitor was expected to be
needed 41.4 percent of the time for a moderate incidence of statin intolerance
and 46.1 percent of the time for a high rate of statin intolerance.
It was expected that adding bempedoic acid would
reduce the demand for a PCSK9 inhibitor by 25.3 percent to 29.4%. As a result,
the annual overall treatment cost of a PCSK9 inhibitor would be reduced by
13.3% and 10.5 percent per 1 million patients with CAD, respectively, for a
moderate and partial rate of statin intolerance. The technique would likewise
reduce the cost per averted event over the full cohort (between –5.0% and
–6.3%), but at the cost of fewer prevented events (between –8.7% and –4.5%).
Lastly, it was calculated that using bempedoic acid
reduced the cost per averted incident (–6.8% for both rates of statin
intolerance), with the number of prevented events being higher in the subset of
patients with full statin intolerance.
Source: Clin Ther
2021;doi:10.1016/j.clinthera.2021.07.019