Pills & # 39; as good as statins & # 39; could benefit hundreds of thousands of patients

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Research suggests that a new alternative to statins could help hundreds of thousands of people at risk for heart disease.

A cholesterol drug called bempedoic acid has been shown to be as effective as statins for lowering cholesterol – but without the same side effects.

A trial conducted by Imperial College London showed that daily tablets could also be taken with statins for those who could not get enough low cholesterol using statins alone.

Professor Kausik Ray, head of the study, said: "Bipedoic acid could be another addition to the arsenal of cholesterol-lowering treatments available to patients.

Statins, the most commonly prescribed drug in the UK, are taken by millions of people in the UK, but some people experience muscle pain as a side effect (picture in stock)

"We have a new class of drugs that could be given to patients already taking statins and could help them further reduce their cholesterol levels and, hence, their potential risk of heart attack and stroke."

About six million Britons take statins, avoiding 80,000 heart attacks and strokes each year, at £ 20 a year per patient.

Six million more people could benefit from the drugs, but do not take them.

Many others start taking drugs, but stop. Between 5 and 20% of people give up because of muscle pain.

The only alternative treatments available to date have been expensive injections called PCSK9 inhibitors – but the NHS hardly uses them because they cost more than £ 4,000 a year.

Professor Ray believes that BEDEDOIC ACID may offer an alternative treatment to those who can not cope with the side effects of statins, but who are not eligible for expensive injections.

The drug has not yet received a price, but as it is a simple chemical – rather than the complex antibody used in PCSK9 inhibitors – experts believe that it will be a lot cheaper.

It could also be used by many people – including some people who have already had a heart attack – who are struggling to lower their cholesterol levels even by using statins.

Professor Ray said, "I would have thought that the number of Britons who could benefit would be several hundred thousand."

His 2,200-person essay, published in the prestigious New England Journal of Medicine, showed that, taken with statins, bempedic acid reduced cholesterol by 18% more than the statin alone.

WHAT IS HIGH CHOLESTEROL?

Cholesterol is a fatty substance essential to the normal functioning of the body.

But too much can cause buildup in the arteries, limiting blood flow to the heart, brain, and the rest of the body.

This increases the risk of angina, heart attack, stroke and blood clots.

Cholesterol is made in the liver and is transported in the blood by proteins.

The first, high density lipoprotein (HDL), transports cholesterol from the cells to the liver where it is broken down or rejected. This is "good cholesterol".

"Bad cholesterol" – low-density lipoprotein (LDL) – transports cholesterol to cells, with excessive amounts then accumulating in the artery walls.

High cholesterol can be genetic, but it is also linked to a diet high in saturated fat, smoking, diabetes, hypertension and family history of stroke or heart disease .

Blood cholesterol is measured in units called millimoles per liter of blood, often abbreviated as mmol / L.

The overall level of a healthy adult should be 5 mmol / L or less, while its LDL level should not exceed 3 mmol / L. An ideal level of HDL is greater than 1 mmol / L.

Cholesterol can be reduced by eating a healthy, low-fat diet; no smoking; and exercise regularly.

If this does not help, cholesterol-lowering drugs such as statins may be prescribed.

Source: NHS

Professor Ray said at the present time that two types of statins are being administered to many people who are struggling to lower their cholesterol levels.

"But if you double the dose of statins, you only get 6% less cholesterol – and some people report more significant side effects."

The pharmaceutical company Esperion, which manufactures bempedoic acid, has already submitted an application for a drug license to the European Medicines Agency. If approved, it could be available next year.

Like statins, bempedoic acid works by blocking a key enzyme used by the body to make cholesterol, ATP-citrate lyase, but in a slightly different way.

The study showed that the treatment was well tolerated by patients, with a higher incidence of gout – due to a slight increase in uric acid levels in the blood – but no incidence increased serious health problems.

Professor Ray added, "One of the main advantages of bempedo acid is supposed to be that it should not cause the muscle-related side effects reported by some users of statins because it is absorbed by the liver and needs to be transformed in its active mode an enzyme that is found only in the liver.

"Once converted into active form, the drug can not leave the liver, so it can not penetrate the muscles and could therefore be of considerable benefit to some.

"It could be an option for patients who are unable to tolerate statins at higher doses, if at all."

In a second study, published in the same journal, the team examined genetic data from more than half a million people in order to model the likely effects of long-term treatment.

This study suggested that, taken alone, bempedoic acid was equally effective in reducing the risk of heart disease.

Professor Sir Nilesh Samani, medical director of the British Heart Foundation, said: "Research has clearly established a link between cholesterol and heart disease. People with high cholesterol may need to associate drugs with a healthy lifestyle to reduce these levels.

"Globally, statins reduce cholesterol.

"However, this new drug could bring real benefit to the few who can not take it or who need additional treatments to get it at the right level.

"Research suggests that it has the potential to reduce the risk of heart attacks and strokes without major side effects."

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