Deepak Bhatt, MD: Choosing Adjunct Therapies for Lowering LDL-C


Discussing how approval of bempedoic acid impacts the role of PCSK9 inhibitors for lowering LDL-C.

While statins are still the standard of care for lowering LDL cholesterol (LDL-C) and will remain so for the foreseeable future, early 2020 brought us the approval of 2 new adjuncts for lowering LDL-C that many are confident could alter the role of PCSK9 inhibitors.

Bempedoic acid and combination bempedoic acid/ezetimibe both received as an adjunct to maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or established atherosclerotic cardiovascular disease (ASCVD) who need additional lowering of LDL-C in February and while this decision was met with praise it was also met with a degree of skepticism.

Even though PCSK9 inhibitors have become more affordable in recent years, data indicates many patients are unable to afford or choose not to continue treatment because of cost. Even with the potential for lower cost, some cardiologists feel more data is warranted as the pivotal CLEAR trials were focused on lowering LDL-C and not outcomes.

We sat down with Deepak Bhatt, MD, MPH, executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital and professor of Medicine at Harvard Medical School, in a special edition ACC.20 House Call to get for more on how these approvals and ongoing research has impacted how clinicians approach treatment algorithms for lowering LDL-C.

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