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Lipid-Lowering Bempedoic Acid Does Not Hasten or Worsen Diabetes

In an analysis of four phase 3 trials, the oral lipid-lowering drug bempedoic acid (Nexletol, Esperion) did not worsen glycemic control or increase the incidence of type 2 diabetes.

As previously reported, this first-in-class drug, which acts by inhibiting adenosine triphosphate-citrate lyase (ACL), was approved by the US Food and Drug Administration in February 2020.

Lawrence A. Leiter MD, from the University of Toronto, Ontario, Canada, delivered the findings of this latest analysis in an oral presentation June 12 at the virtual American Diabetes Association (ADA) 80th Scientific Sessions.

"The current study is important as it shows overall consistent efficacy and safety regardless of glycemic status and no increase in new-onset diabetes," Leiter told Medscape Medical News in an email.

There is interest in how lipid-lowering drugs might affect glycemia because "meta-analyses have shown about a 10% increased risk of new-onset diabetes in statin users, although the absolute increased risk is one extra case per 255 treated patients (in whom one would expect 5.4 cardiovascular events to be prevented by the statin)," he noted.Although statins have a slight effect of worsening glucose tolerance and a modest effect of increasing cases of new-onset diabetes, the current research shows that "bempedoic acid appears to be free of these effects".


  1. ADA 80th Scientific Sessions. June 12, 2020. Abstract 185-OR.