Evidence map›Paper›PMID 33514449›Full record

Trial reportAtherosclerosis2021

Combination of bempedoic acid, ezetimibe, and atorvastatin in patients with hypercholesterolemia: A randomized clinical trial.

John Rubino, Diane E MacDougall, Lulu R Sterling, Jeffrey C Hanselman, Stephen J Nicholls

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
9.2field-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.

NCT07255820 phase4completedstarted 2026, after this paper: background citation

Comparative Efficacy and Safety of Dual Versus Triple Lipid-Lowering Therapies (Rosuvastatin/Ezetimibe, Bempedoic Acid/Ezetimibe, and Rosuvastatin/Ezetimibe/Bempedoic Acid ) in Type 2 Diabetes Mellitus Patients With Elevated LDL Cholesterol

Ran2026Enrolled126Registered outcomes8Posted comparisons0ConditionsHypercholesterolemia / Elevated LDL Cholesterol, Type 2 Diabetes MellitusArmsBempedoic Acid + Ezetimibe, Rosuvastatin + Ezetimibe, Rosuvastatin + Ezetimibe + Bempedoic Acid
PMID 36876740PMID 31714986PMID 31357887PMID 32980290PMID 34980867PMID 35346603PMID 39330344other papers from this trial
Open the trial in the graph
NCT03051100 phase2completednot on this map

A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of Triplet Therapy With Bempedoic Acid (ETC 1002) 180 mg, Ezetimibe 10 mg, and Atorvastatin 20 mg in Patients With Elevated LDL C

TypeinterventionalSponsorEsperion Therapeutics, Inc.Ran2017 to 2017Enrolled63ConditionsHypercholesterolemiaArmsBempedoic acid 180mg, Ezetimibe 10mg, Atorvastatin 20mg, Placebo
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
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  8. 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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  10. Cardiovascular risk management beyond statins: review of new therapies available in Italy.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

John RubinoPMG Research of Raleigh, Raleigh, NC, USA.
Diane E MacDougallEsperion Therapeutics, Inc., Ann Arbor, MI, USA.
Lulu R SterlingEsperion Therapeutics, Inc., Ann Arbor, MI, USA.
Jeffrey C HanselmanEsperion Therapeutics, Inc., Ann Arbor, MI, USA.
Stephen J NichollsMonash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia. Electronic address: stephen.nicholls@monash.edu.
Esperion Therapeutics (United States) · USMonash University · AUPMG Research · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsMany patients with hypercholesterolemia fail to achieve sufficient low-density lipoprotein cholesterol (LDL-C) lowering despite use of guideline-recommended lipid-lowering therapies. This study evaluated LDL-C lowering with the combination of bempedoic acid, ezetimibe, and atorvastatin.

methodsThis was a phase 2, randomized, double-blind, placebo-controlled study (NCT03051100). After washout of lipid-lowering drugs, patients were randomized 2:1 to triple therapy (bempedoic acid 180 mg, ezetimibe 10 mg, and atorvastatin 20 mg; n = 43) or placebo (n = 20) once daily for 6 weeks. The primary endpoint was percent change from baseline in LDL-C at week 6.

resultsMean age for the 63 randomized patients was 61.2 years; baseline LDL-C was 154.8 mg/dL. At week 6, mean LDL-C lowering with triple therapy (-63.6%) was significantly greater than with placebo [-3.1%; difference, -60.5% [(95% CI, -68.0% to -53.0%); p < 0.001]. Significant reductions with triple therapy vs. placebo were also observed for non-high-density lipoprotein cholesterol, total cholesterol, apolipoprotein B, and high-sensitivity C-reactive protein (p < 0.001 for all). With triple-therapy, 90% of patients achieved LDL-C <70 mg/dL and 95% of patients had ≥50% lower LDL-C from baseline to week 6; no patients in the placebo group met either goal. The majority of treatment-emergent adverse events were mild to moderate in severity. No patients experienced clinically relevant elevations in aminotransferase or creatine kinase levels.

conclusionsAmong patients with hypercholesterolemia, the combination of bempedoic acid, ezetimibe, and atorvastatin significantly lowered LDL-C, allowing more than 90% of patients in this study to reach guideline-recommended LDL-C goals.

Indexed as

Anticholesteremic AgentsHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaAtorvastatinDicarboxylic AcidsDouble-Blind MethodDrug Therapy, CombinationEzetimibeFatty AcidsHumansMiddle AgedTreatment Outcome8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acidAnticholesteremic AgentsAtorvastatinDicarboxylic AcidsEzetimibeFatty AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsBempedoic acidEzetimibeHypercholesterolemiaLipid-lowering therapyLow-density lipoprotein cholesterolStatin

Identifiers

PMID33514449
OpenAlexW3118166189

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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 Socratic graph.