Evidence map›Paper›PMID 38017541›Full record

SynthesisCardiovascular diabetology2023

Safety and efficacy of bempedoic acid: a systematic review and meta-analysis of randomised controlled trials.

Ovidio De Filippo, Fabrizio D'Ascenzo, Mario Iannaccone, Maurizio Bertaina, Attilio Leone, Irene Borzillo, Emanuele Ravetti, Andrea Solano, Ilaria Pagliassotto, Marco Nebiolo and 7 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Guideline
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  14. Three months of bempedoic acid treatment does not affect cystatin C-based estimation of glomerular filtration rate.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

Ovidio De FilippoDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Fabrizio D'AscenzoDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy. fdascenzo@cittadellasalute.to.it.
Mario IannacconeDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città Di Torino, Turin, Italy.
Maurizio BertainaDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città Di Torino, Turin, Italy.
Attilio LeoneDepartment of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Irene BorzilloDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Emanuele RavettiDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Andrea SolanoDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Ilaria PagliassottoDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Marco NebioloDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Francesco BrunoDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Federico GiacobbeDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
Saverio MuscoliDivision of Cardiology, Fondazione Policlinico "Tor Vergata", Rome, Italy.
Silvia MonticoneDepartment of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy.
Maria Felice BrizziDivision of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy.
Giuseppe Biondi ZoccaiDepartment of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
Gaetano Maria De FerrariDivision of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
University of Turin · ITAzienda Ospedaliera Citta' della Salute e della Scienza di Torino · ITOspedale San Giovanni Bosco · ITPoliclinico Tor Vergata · ITSapienza University of Rome · ITUniversity of Naples Federico II · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsBempedoic Acid (BA) is a novel Lipid-Lowering Therapy (LLT). We performed a systematic review and meta-analysis to assess the efficacy and safety of BA in patients with hypercholesterolemia.

methodsPubMed, Scopus, and Cochrane library databases were searched for randomised controlled trials evaluating the efficacy and/or safety of BA compared with placebo. Trials investigating dosages other than 180 mg/die were excluded. Major adverse cardiovascular events (MACE) were the primary efficacy endpoint. LDL-cholesterol reduction was the primary laboratory endpoint. Pre-specified safety endpoints included muscle-related adverse events, new-onset diabetes, and gout. The protocol was registered on PROSPERO (temporary ID:399,867).

resultsStudy search identified 275 deduplicated results. 11 studies, encompassing 18,315 patients (9854 on BA vs 8461 on placebo/no treatment) were included. BA was associated with a reduced risk of MACE (OR 0.86, 95% CI 0.79-0.95), myocardial infarction (OR 0.76, 95% CI 0.64-0.88) and unstable angina (OR 0.69, 95% CI 0.54-0.88) compared to control, over a median follow up of 87 (15-162) weeks. BA was associated with a reduction of LDL-Cholesterol (mean difference [MD]-22.42,95% CI - 24.02% to - 20.82%), total cholesterol (- 16.50%,95% - 19.21% to - 13.79%), Apo-B lipoprotein (- 19.55%, - 22.68% to - 16.42%) and high-sensitivity CRP (- 27.83%, - 31.71% to - 23.96%) at 12 weeks. BA was associated with a higher risk of gout (OR 1.55, 95% CI 1.27-1.90) as compared with placebo. Efficacy on laboratory endpoints was confirmed, with a variable extent, across patients on statin or ezetimibe background therapy.

conclusionsThe improved cholesterol control achieved with BA translates into a reduced risk of MACE, including myocardial infarction and coronary revascularisation. The drug has a satisfactory safety profile except for an increased risk of gout.

Indexed as

GoutHydroxymethylglutaryl-CoA Reductase InhibitorsMyocardial InfarctionCholesterolCholesterol, LDLDicarboxylic AcidsFatty AcidsHumansRandomized Controlled Trials as TopicTreatment Outcome8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acidCholesterolCholesterol, LDLDicarboxylic AcidsFatty AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsBempedoic acidCardiovascular outcomesHypercholesterolemiaMeta-analysis

Identifiers

PMID38017541
PMCPMC10685600
OpenAlexW4389083456

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.