Is Nexlizet (bempedoic acid and ezetimibe) an effective medication?

From the Guidelines

Nexlizet is a good medicine for certain patients with high cholesterol, particularly those who need additional LDL cholesterol lowering beyond what statins alone can provide, as it can lower LDL cholesterol by 38% and reduce the risk of major adverse cardiovascular events by 13% 1. Nexlizet combines bempedoic acid (180 mg) and ezetimibe (10 mg) in a single daily pill, working through dual mechanisms to reduce cholesterol production in the liver and decrease cholesterol absorption in the intestines. Some key points to consider when prescribing Nexlizet include:

• The medication is most appropriate for adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who need additional LDL lowering.
• Common side effects include muscle pain, joint pain, diarrhea, and upper respiratory infections.
• Nexlizet should be taken once daily with or without food, and patients should continue following a heart-healthy diet and exercise regimen while taking it.
• The medication may interact with certain other drugs, so patients should inform their doctor about all medications they take.
• The CLEAR Outcomes trial found a reduction in four-point major adverse cardiovascular events by 13% compared with placebo for individuals with established ASCVD or at high risk for ASCVD considered to be intolerant to statin therapy 1.
• Prespecified subanalyses evaluated the impact for individuals with diabetes and showed a 17% reduction in four-point major adverse cardiovascular events when treated with bempedoic acid 1. While effective for many patients, whether Nexlizet is "good" depends on individual patient factors, cholesterol levels, cardiovascular risk, and tolerance of the medication. Some of the benefits of Nexlizet include:
• Dual mechanism of action to reduce cholesterol production and absorption
• Once-daily dosing
• Potential to reduce major adverse cardiovascular events However, it is essential to weigh these benefits against the potential risks and side effects, and to consider individual patient factors and medical history when deciding whether Nexlizet is a good medicine for a particular patient.

From the Research

Efficacy of Nexlizet

• Nexlizet, a combination of bempedoic acid and ezetimibe, has been shown to be effective in lowering low-density lipoprotein cholesterol (LDL-C) levels in patients with hypercholesterolemia 2, 3, 4.
• Studies have demonstrated that Nexlizet can reduce LDL-C levels by up to 36.2% compared to placebo, and is more effective than ezetimibe or bempedoic acid alone 4.
• The combination of bempedoic acid and ezetimibe has also been shown to improve other lipid parameters, such as total cholesterol and non-high-density lipoprotein cholesterol, and to reduce high-sensitivity C-reactive protein levels 2, 3.

Safety Profile

• The safety profile of Nexlizet has been evaluated in several studies, and has been found to be generally similar to that of bempedoic acid, ezetimibe, or placebo 2, 3, 4.
• The majority of treatment-emergent adverse events reported in studies of Nexlizet have been mild to moderate in severity, and no patients have experienced clinically relevant elevations in aminotransferase or creatine kinase levels 3.

Patient Populations

• Nexlizet may be particularly beneficial for patients with high cardiovascular risk who are unable to achieve sufficient LDL-C lowering with statin therapy alone 5.
• The combination of bempedoic acid and ezetimibe has been shown to be effective in patients with hypercholesterolemia and high cardiovascular disease risk, including those with atherosclerotic cardiovascular disease, heterozygous familial hypercholesterolemia, or multiple cardiovascular disease risk factors 4.