From the Guidelines
Nexlizet typically lowers LDL cholesterol by about 38% on average. This medication combines bempedoic acid and ezetimibe, working through dual mechanisms to reduce cholesterol. Bempedoic acid inhibits an enzyme called ATP-citrate lyase that's involved in cholesterol production in the liver, while ezetimibe blocks cholesterol absorption in the small intestine. The standard dose is one tablet daily, containing 180 mg of bempedoic acid and 10 mg of ezetimibe, taken with or without food. Patients may see results within the first few weeks of treatment, but the full effect is usually observed after about 4 weeks of consistent use. Nexlizet is generally prescribed for adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who need additional LDL lowering beyond maximally tolerated statin therapy. It's essential to continue any prescribed statin medication while taking Nexlizet unless otherwise directed by your healthcare provider, as the combination can provide complementary cholesterol-lowering effects 1.
Some key points to consider when prescribing Nexlizet include:
- The medication is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established ASCVD who require additional lowering of LDL cholesterol.
- Bempedoic acid, a component of Nexlizet, has been shown to lower LDL cholesterol levels by about 17% to 18% when used in combination with statin therapy 1.
- The combination of bempedoic acid and ezetimibe in Nexlizet has been shown to result in a 38% reduction in LDL-C 1.
- Patients with a history of gout or tendon rupture should use bempedoic acid with caution, as it may increase the risk of these conditions 1.
- The cost and prior authorization may represent challenges in the implementation of Nexlizet, but patient assistance programs and discount copay cards are available for eligible patients 1.
It's also worth noting that more recent studies, such as the one published in 2024, suggest that bempedoic acid therapy lowers LDL cholesterol levels by about 23% compared with placebo 1. However, the most relevant and highest-quality study for determining the LDL-lowering effect of Nexlizet is still the one that reports a 38% reduction in LDL-C 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
LDL Reduction with Nexlizet
- Nexlizet, also known as bempedoic acid, is a medication used to lower low-density lipoprotein (LDL) cholesterol levels.
- According to a study published in 2021, bempedoic acid added to proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor therapy significantly lowered LDL-C by 30.3% 2.
- Another study published in 2023 found that bempedoic acid reduced LDL-C levels by 55.9% in patients with high cardiovascular risk who were not achieving their LDL-C goals despite treatment with PCSK9 inhibitors and/or statins and ezetimibe 3.
- The exact amount of LDL reduction with Nexlizet may vary depending on the individual patient and their specific treatment regimen.
Comparison to Other Medications
- Bempedoic acid has been shown to be effective in lowering LDL-C levels when used in combination with other medications, such as statins and ezetimibe 4, 2.
- PCSK9 inhibitors, such as alirocumab and evolocumab, have also been shown to be effective in lowering LDL-C levels, but may have a higher cost and more adverse events compared to bempedoic acid 5, 6.
- The choice of medication for lowering LDL-C levels will depend on the individual patient's needs and medical history.
Safety and Efficacy
- Bempedoic acid has been shown to have a safe and effective profile when used to lower LDL-C levels 2, 3.
- The medication has been well-tolerated in clinical trials, with few adverse events reported 4, 6.
- Ongoing clinical trials are being conducted to further evaluate the safety and efficacy of bempedoic acid in reducing cardiovascular events.