Dear Joe and Teresa Graedon: I’ve been reading about bempedoic acid as an alternative to statins to prevent heart attacks. It is marketed under the brand name Nexletol. I hope you can interpret the results of the recent study for your readers.
The authors report a 23% lower risk. I believe that is a relative risk number, which is most useful for marketing expensive drugs. I would like to know the absolute risk reduction. Can you enlighten us?
A. Thank you for this very sophisticated question about the recent study (New England Journal of Medicine, March 4, 2023). Most of the news reports about bempedoic acid have emphasized the 23% relative risk reduction in heart attacks. That certainly sounds impressive.
Drilling down on the data, however, reveals that 3.7% of people taking Nexletol had heart attacks during the more than three years of the study. In comparison, 4.8% of those on placebo had heart attacks. That absolute difference is 1.1%.
When it came to survival, the two groups cannot be told apart. Of those on the medication, 6.2% died from any cause. That is almost identical to the 6.0% who died while taking placebo.
According to GoodRx, a month’s supply of Nexletol could cost over $460. That makes it substantially pricier than statins unless insurance covers it.
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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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