Medication

New Options for Treatment of High Cholesterol

In late February, the U.S. Food and Drug Administration (FDA) approved a new medication for the treatment of high cholesterol. The medication, called Nexletol (bempedoic acid), is meant to be used in combination with a healthy diet and statin therapy to treat high cholesterol in adults. The medication is specifically approved for individuals who have not reached their target levels of low-density lipoprotein (LDL) cholesterol and need additional interventions to lower these levels. This includes individuals with heterozygous familial hypercholesterolemia (HeFH) and/or atherosclerotic cardiovascular disease.

LDL cholesterol is also known as the “bad” cholesterol because it contributes to the buildup of fatty plaques in the arteries (atherosclerosis). Atherosclerosis is a condition that can narrow the arteries, which in turn, increases a person’s risk for heart attack, stroke, and peripheral artery disease.

Individuals with familial hypercholesterolemia (FH) have a mutation in one of the genes that regulates how cholesterol is cleared by the body. Thus, people with FH tend to have higher LDL levels.

Studies of Nexletol showed an 18% reduction in LDL cholesterol in individuals already taking a moderate to high dose of statins. In individuals who could only tolerate low doses of statins or who could not tolerate statins at all, there was a 28% reduction in LDL cholesterol.

The approval of Nexletol is an exciting development as it gives health care providers another tool in the fight against heart disease, the number one killer of Americans. Statins, a type of medication used to treat high cholesterol, are a common choice for treatment, along with diet and exercise. However, statins have potential side effects, including muscle aches and pain, which can make treatment challenging. In an interview with The Washington Post, Dr. Robert Rosenson, Director of Cardiometabolic Disorders for Mount Sinai Hospital, stated that one of the benefits of Nexletol is that because the drug “targets an enzyme in the liver, not in the muscles, it doesn’t cause muscle pain.”

Individuals with FH or atherosclerotic cardiovascular disease who are taking a statin and have high LDL cholesterol may wish to discuss the option of Nexletol with their health care providers.