Researchers tested a new cholesterol-lowering drug called bempedoic acid to see if it would damage muscle cells like some other heart medications do. They compared it to a common drug called atorvastatin in mice with high cholesterol. The good news: bempedoic acid reduced dangerous plaque buildup in arteries without hurting the tiny energy factories inside muscle cells. In contrast, atorvastatin did damage these energy centers. This suggests bempedoic acid might be a safer option for people who can’t take traditional cholesterol drugs.

The Quick Take

  • What they studied: Whether a new cholesterol-lowering drug called bempedoic acid damages the energy-producing parts of muscle cells, compared to a traditional cholesterol drug
  • Who participated: Female mice genetically modified to have high cholesterol, fed a diet high in fat and cholesterol for 12 weeks
  • Key finding: Bempedoic acid successfully reduced dangerous plaque in arteries without damaging muscle cell energy centers, while the traditional drug atorvastatin did cause damage to these energy centers
  • What it means for you: If you can’t take traditional cholesterol medications, bempedoic acid may be a safer alternative that protects your heart without the muscle-damaging side effects. However, this was tested in mice, so human studies are still needed before drawing firm conclusions

The Research Details

Scientists used female mice that were genetically engineered to develop high cholesterol naturally. They fed these mice a diet high in fat and cholesterol for 12 weeks to mimic unhealthy eating habits. During this time, some mice received bempedoic acid (the new drug), some received atorvastatin (a common cholesterol drug), and some received no treatment as a control group.

The researchers then examined the mice’s arteries using special imaging techniques to measure plaque buildup. They also tested the muscle cells’ energy-producing structures (called mitochondria) using a technique called mitostress analysis, which measures how well these energy centers work. Finally, they looked at muscle tissue under an electron microscope to see if the drug treatments changed the shape or structure of the mitochondria.

Understanding how different cholesterol drugs affect muscle health is important because some patients experience muscle pain and weakness from traditional cholesterol medications. If a new drug can lower cholesterol without these side effects, it could help millions of people who currently can’t tolerate standard treatments. This research helps identify which drugs are safer for long-term use.

This study used multiple testing methods to verify results, which strengthens confidence in the findings. The researchers measured several different aspects of muscle function and structure rather than relying on a single test. However, this was conducted in mice, not humans, so results may not directly apply to people. The study also didn’t specify the exact number of mice used, which makes it harder to assess statistical reliability.

What the Results Show

After 12 weeks of treatment, bempedoic acid successfully reduced the amount of dangerous plaque buildup in the mice’s arteries, particularly in the chest and belly areas. The drug also reduced the size of the necrotic core (the dead tissue inside plaques), which is important because larger necrotic cores are more dangerous.

When researchers tested how well the muscle cells’ energy centers worked, they found a striking difference between the two drugs. Mice treated with bempedoic acid had normal energy production in their muscles—just like the untreated control mice. In contrast, mice treated with atorvastatin showed significant reductions in how much energy their muscle mitochondria could produce, both at rest and during activity.

The atorvastatin group also showed reduced overall energy expenditure and oxygen consumption, suggesting their muscles were working less efficiently. When scientists examined muscle tissue under a microscope, they found that atorvastatin caused the mitochondria to become fragmented and disorganized, while bempedoic acid left the mitochondrial structure normal and healthy.

Body weight, food intake, blood sugar levels, and liver function tests were all unaffected by bempedoic acid treatment, suggesting the drug was well-tolerated without obvious side effects in these mice. This contrasts with some other cholesterol drugs that can affect liver function or cause weight changes.

Previous research suggested that statins (a common class of cholesterol drugs) might damage the energy-producing structures in muscle cells, which could explain why some patients experience muscle pain. This study confirms that concern for atorvastatin while showing that bempedoic acid, which works through a different mechanism, does not cause this problem. This finding supports the idea that different cholesterol-lowering drugs have different effects on muscle health.

The most important limitation is that this research was conducted in mice, not humans. Mice metabolize drugs differently than people do, so results may not directly translate. The study didn’t specify how many mice were used in each group, making it difficult to assess whether the sample size was large enough to detect real differences. Additionally, the study only lasted 12 weeks, so we don’t know if these effects would continue or change over longer periods. Finally, this was a preliminary study designed to test a hypothesis; larger, longer human studies would be needed to confirm these findings apply to people.

The Bottom Line

Based on this research, bempedoic acid appears to be a promising alternative for people who cannot tolerate traditional cholesterol medications. However, confidence in this recommendation is moderate because the study was conducted in mice. If you’re unable to take standard cholesterol drugs due to side effects, discuss bempedoic acid with your doctor as a potential option. Do not stop taking prescribed cholesterol medication without medical guidance.

This research is most relevant to people who experience muscle pain, weakness, or other side effects from traditional cholesterol drugs like statins. It’s also important for doctors treating patients with high cholesterol who have statin intolerance. People with normal cholesterol levels don’t need to be concerned about this research. This is not yet a recommendation for healthy people to take bempedoic acid.

In this mouse study, benefits appeared after 12 weeks of treatment. If bempedoic acid works similarly in humans, you might expect to see changes in cholesterol levels within weeks, though the full cardiovascular benefits would likely take months to years to develop, similar to other cholesterol medications.

Want to Apply This Research?

  • If prescribed bempedoic acid, track your cholesterol levels (LDL, HDL, and total cholesterol) every 4-6 weeks initially, then every 3 months once stable. Also monitor for any muscle pain, weakness, or fatigue and log these symptoms daily to identify patterns.
  • Use the app to set reminders for taking bempedoic acid at the same time daily, and log any side effects or improvements you notice. Create a simple rating scale (1-10) for muscle pain or fatigue to track whether the drug is better tolerated than previous medications.
  • Establish a baseline of your current symptoms and energy levels before starting the medication. Then track weekly for the first month, then bi-weekly for three months to see if muscle-related side effects improve compared to previous cholesterol medications. Share this data with your doctor at follow-up appointments.

This research was conducted in mice and has not yet been tested in humans. While the findings are promising, they do not constitute medical advice. Bempedoic acid is a real medication approved by the FDA, but decisions about whether to take it should be made with your healthcare provider based on your individual health situation, medical history, and current medications. Do not start, stop, or change any cholesterol medication without consulting your doctor. If you experience muscle pain, weakness, or other concerning symptoms while taking any cholesterol medication, contact your healthcare provider immediately.