Trial reportJournal of the American Heart Association2026

Efficacy and Safety of Bempedoic Acid in Patients Aged ≥75 Years Stratified by Varying Statin Exposure: Results From Phase 3 Studies of Bempedoic Acid.

G B John Mancini, A Michael Lincoff, Anne C Goldberg, Christine Broestl, Na Li, P Barton Duell, Ulrich Laufs, Alberico L Catapano, Lawrence A Leiter, Maciej Banach and 6 more

Erratum issuedAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Heart Association, 2026. The graph read 2 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 2. An erratum has been issued. Not yet cited in PubMed.

2numbers the graph read from it
2cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

← favours the treatmentfavours the comparator →
-23.10 · no effect
Lipidsfavours the treatment · against placebo · ascvd, dyslipidemiafeeds one cell of the map
change -18.4-21.3 to -15.6
Placebo-corrected mean percentage change in LDL-C at week 12 in the max-statin pool with bempedoic acid was -18.4% (95% CI, -21.3 to -15.6) for patients aged 18 to <65 years, -18.6% (95% CI, -21.2 to -16.1) for 65 to <75 years, and -18.3% (95% CI, -22.2 to -14.5) for ≥75 years.
Lipidsfavours the treatment · against placebo · ascvd, dyslipidemiafeeds one cell of the map
change -21.9-23.1 to -20.7
In the statin-intolerant pool, LDL-C change was -21.9% (95% CI, -23.1 to -20.7) for patients aged 18 to <65 years, -22.9% (95% CI, -24.0 to -21.8) for 65 to <75 years, and -24.5% (95% CI, -26.2 to -22.7) for ≥75 years.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Other lipid agents×lipids

SupportsOpen on the map →What to test next →

28 readable studies in this cell: 18 favour the treatment, 1 find no difference, 9 favour the comparator.

Belief with this paper
0.50contested · 15 families support, 6 contradict · against placebo
Without it
0.50This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2026
change -18.4-21.3 to -15.6
NCT004793881,216 enrolled · 2007
Δ -4.50-7.70 to -1.30
NCT00862251808 enrolled · 2009
Percent change in least-square means -14.8-19.6 to -9.91
NCT00485758796 enrolled · 2007
Δ -17.9-21.4 to -14.4
NCT00730132712 enrolled · 2008
Δ -5.75-9.43 to -2.07
NCT01763827615 enrolled · 2013
Δ -39.3-43.3 to -35.3
NCT01984424511 enrolled · 2013
Δ -37.8-42.3 to -33.3
NCT06005597407 enrolled · 2024
Least Squares (LS) Means -27.9-37.5 to -18.4
NCT03337308382 enrolled · 2017
Δ -38.0-46.5 to -29.6
NCT02227784366 enrolled · 2014
Δ -6.14-12.2 to -0.22
NCT01763905307 enrolled · 2013
Δ -38.1-43.7 to -33.0
NCT03001076269 enrolled · 2016
Δ -28.4-34.4 to -22.5

Statins×lipids

SupportsOpen on the map →What to test next →

38 readable studies in this cell: 26 favour the treatment, 5 find no difference, 7 favour the comparator.

Belief with this paper
0.50contested · 21 families support, 7 contradict · against placebo
Without it
0.50This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2026
change -21.9-23.1 to -20.7
NCT002899002,340 enrolled · 2006
Δ -13.2-16.8 to -9.60
reduced -66.0-73.0 to -58.0
NCT02546323543 enrolled · 2015
Δ -35.5-40.2 to -30.7
NCT01678820299 enrolled · 2012
Δ 0.50-4.80 to 5.80
NCT01218204287 enrolled · 2010
Δ 5.47-15.7 to 26.7
NCT0093525931 enrolled · 2009
Δ -51.7
reductions -33.6-38.8 to -28.4
4 · 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.

5 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

16 authors.

G B John ManciniCentre for Cardiovascular Innovation Vancouver Hospital Vancouver BC Canada.ORCID 0000-0002-2419-1476
A Michael LincoffDepartment of Cardiovascular Medicine Cleveland Clinic Foundation Cleveland OH USA.ORCID 0000-0001-8175-2121
Anne C GoldbergWashington University St. Louis MO USA.
Christine BroestlEsperion Therapeutics, Inc. Ann Arbor MI USA.
Na LiEsperion Therapeutics, Inc. Ann Arbor MI USA.ORCID 0000-0002-7709-5664
P Barton DuellCenter for Preventive Cardiology, Knight Cardiovascular Institute Oregon Health and Science University Portland OR USA.ORCID 0000-0002-0208-5154
Ulrich LaufsClinic for Cardiology University of Leipzig Medical Center Leipzig Germany.ORCID 0000-0003-2620-9323
Alberico L CatapanoIRCCS MultiMedica, Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy.ORCID 0000-0002-7593-2094
Lawrence A LeiterDivision of Endocrinology and Metabolism, St Michael's Hospital-Unity Health Toronto, Department of Medicine University of Toronto Toronto ON Canada.ORCID 0000-0002-1040-6229
Maciej BanachMedical University of Lodz Lodz Poland.ORCID 0000-0001-6690-6874
Peter M HeroutEsperion Therapeutics, Inc. Ann Arbor MI USA.ORCID 0000-0002-4129-4119
Stephen J NichollsVictorian Heart Institute Monash University Melbourne VIC Australia.ORCID 0000-0002-9668-4368
LeAnne BloedonEsperion Therapeutics, Inc. Ann Arbor MI USA.
Heather A PowellEsperion Therapeutics, Inc. Ann Arbor MI USA.
Steven E NissenDepartment of Cardiovascular Medicine Cleveland Clinic Foundation Cleveland OH USA.ORCID 0000-0002-7231-6464
Debabrata MukherjeeDepartment of Internal Medicine, Division of Cardiology Texas Tech University Health Science Center El Paso TX USA.ORCID 0000-0002-5131-3694

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundLowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of major vascular events across all age groups. We analyzed phase 3 studies of bempedoic acid to characterize the safety and efficacy in patients aged ≥75 years with and without a concomitant statin.

methodsPost hoc analysis of bempedoic acid in high-risk patients with cardiovascular disease by age from phase 3 placebo-controlled, randomized clinical trials: two 52-week primary hyperlipidemia studies with maximal background statin ("max-statins pool"), and 1 cardiovascular outcomes trial ("statin-intolerant pool"). Efficacy (LDL-C, non-high-density lipoprotein cholesterol, total cholesterol, high-sensitivity C-reactive protein) and safety were evaluated.

resultsThe max-statins pool included 3009 (2010 bempedoic acid, 999 placebo) patients. The statin-intolerant pool included 13 970 patients (6992 bempedoic acid, 6978 placebo). In total 7022 patients were aged 18 to <65 years; 7372 were aged 65 to <75 years; 2585 were aged ≥75 years. Placebo-corrected mean percentage change in LDL-C at week 12 in the max-statin pool with bempedoic acid was -18.4% (95% CI, -21.3 to -15.6) for patients aged 18 to <65 years, -18.6% (95% CI, -21.2 to -16.1) for 65 to <75 years, and -18.3% (95% CI, -22.2 to -14.5) for ≥75 years. In the statin-intolerant pool, LDL-C change was -21.9% (95% CI, -23.1 to -20.7) for patients aged 18 to <65 years, -22.9% (95% CI, -24.0 to -21.8) for 65 to <75 years, and -24.5% (95% CI, -26.2 to -22.7) for ≥75 years. Frequency of adverse events compared with placebo was similar across the ages, but more frequent among patients ≥75 years regardless of background statin. Cardiovascular event reduction was statistically comparable across all ages.

conclusionsBempedoic acid was well tolerated in patients aged ≥75 years with efficacy and safety comparable with younger subgroups regardless of background statin usage. Bempedoic acid may be considered a viable strategy for managing hypercholesterolemia in adults, regardless of age.

Indexed as

Cardiovascular DiseasesDicarboxylic AcidsFatty AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsAgedAged, 80 and overAge FactorsBiomarkersCholesterol, LDLDrug Therapy, CombinationFemaleHumansMaleTreatment Outcome8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acidBiomarkersCholesterol, LDLDicarboxylic AcidsFatty AcidsHydroxymethylglutaryl-CoA Reductase Inhibitorsbempedoic acidelderlyLDL‐Cmuscle painsafetystatinstatin intolerant

Identifiers

PMID42333640
PMCPMC13477405

What Socratic holds

Texttitle and abstract
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 Socratic graph.