Abstract Introduction Bempedoic acid (BA) is an inhibitor of adenosine triphosphate-citrate lyase that reduces cholesterol synthesis. Its current indication and funding are for patients who do not achieve their lipid goals despite maximum doses of statins and ezetimibe or those with intolerance/contraindication to these treatments. The aim of this study was to evaluate the effectiveness, safety, and adherence to BA treatment in a real-world older population. Material and Methods We conducted a descriptive, retrospective, single-centre observational study. Patients treated with BA from September 2023 to March 2024 were included. Patients were classified into two groups based on age (70 and ≥ 70 years). Demographic, clinical, and analytical variables were analyzed. Effectiveness was assessed as the reduction in plasma LDL cholesterol levels and achievement of lipid goals (LDL cholesterol 55 mg/dL). Adherence was defined as the collection of at least 75% of the prescribed packages during the follow-up period. Adverse reactions (AR) were monitored during the follow-up. IBM-SPSS-Statistics was used for statistical analysis. Results A total of 80 patients were included (31 patients ≥70 years), most of whom started treatment with BA for secondary prevention. The main characteristics are summarized in the Table. Regarding baseline characteristics, there was a trend for higher statin intolerance in younger patients (42% vs 22%, p=0.06). There were no differences in lipid treatment before starting BA (statins 89%; ICPSK 8.2 vs 6.5%) or in treatment adherence between the two subgroups. Regarding cholesterol levels, BA treatment was associated with a similar reduction in both age groups (total cholesterol reduction 25% vs 20%, LDL cholesterol 37% vs 32%, non-HDL cholesterol 30% vs 20%, all p0.05). The rate of AR during short-term follow-up was low (2%), with no differences between older and younger patients. Conclusions BA treatment in older patients is associated with a reduction in lipid parameters similar to that observed in younger populations, with a comparable safety profile. BA constitutes a new tool in the therapeutic arsenal for managing dyslipidemia in older patients.Table
Mendez et al. (Sat,) studied this question.
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