{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:39:03Z","timestamp":1792787943392,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","id":[{"id":"https:\/\/ror.org\/001w7jn25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lipids Health Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dyslipidaemia remains a leading cause of death in Germany despite an improving therapeutic landscape, with many patients not achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals. Bempedoic acid, an adenosine triphosphate citrate lyase inhibitor, is a recent addition to the therapeutic landscape with proven efficacy in randomised controlled trials; however, its use varies between centres. We aimed to assess the short-term, real-world effectiveness of bempedoic acid in lowering LDL-C levels in patients in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, observational study was conducted using data from patients with primary hypercholesterolaemia or mixed dyslipidaemia, collected before and approximately 3 months after initiating bempedoic acid in 7 specialised lipid outpatient clinics in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data were analysed from a total of 641 patients, with a mean age (standard deviation [SD]) of 63.2 (11.3) years. The addition of bempedoic acid significantly reduced LDL-C levels from a mean of 133.6 mg\/dL at baseline to 101.8 mg\/dL after 3 months (p &lt; 0.001). The mean within-patient LDL-C reduction was 31.8 mg\/dL and the mean patient-level percentage change was -17.5%. Mean patient-level changes were -4.9% for HDL-C and -12.0% for total cholesterol; triglycerides did not change significantly. At 3 months, patients not receiving any lipid-lowering therapy (LLT) other than bempedoic acid had a mean patient-level LDL-C reduction of 27.1%; corresponding mean reductions were 23.7% with ezetimibe, 20.3% with PCSK9 inhibitor therapy, 9.0% with statin therapy and 6.1% with statin plus ezetimibe. Suspected adverse events were documented in 218\/641 patients (34.0%), and 171\/641 (26.7%) had discontinued bempedoic acid by follow-up. Myalgia was the most commonly reported adverse event in patients discontinuing treatment (75 cases).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings from this real-world, multicentre study conducted in Germany show that bempedoic acid may present an effective treatment option for patients with hypercholesterolaemia who are already receiving LLT, in addition to being an effective option for patients not receiving\/tolerating other LLTs. The magnitude of LDL-C reduction differed across background treatment strategies, while suspected adverse events and treatment discontinuation were common in this specialist-care cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12944-026-03062-6","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:44:40Z","timestamp":1789789480000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world use of bempedoic acid for hypercholesterolaemia: a German multicentre, retrospective, cohort study"],"prefix":"10.1186","volume":"25","author":[{"given":"Linus","family":"Haberbosch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Baessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"de Ruiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius L.","family":"Katzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"K\u00f6nemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Schatz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Mai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Kassner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bobbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"3062_CR1","unstructured":"Robert Koch Institut. Cardiovascular diseases. 2025. Available from: https:\/\/www.gbe.rki.de\/EN\/Topics\/HealthStatus\/PhysicalHealth\/CardiovascularDiseases\/CardiovascularDiseases_node.html."},{"issue":"1","key":"3062_CR2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","volume":"41","author":"F Mach","year":"2020","unstructured":"Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111\u201388.","journal-title":"Eur Heart J"},{"issue":"10","key":"3062_CR3","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1038\/s41569-024-01039-5","volume":"21","author":"BA Ference","year":"2024","unstructured":"Ference BA, Braunwald E, Catapano AL. The LDL cumulative exposure hypothesis: evidence and practical applications. 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N Engl J Med. 2019;380(11):1022\u201332.","journal-title":"N Engl J Med"},{"issue":"6","key":"3062_CR14","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1177\/2047487319864671","volume":"27","author":"CM Ballantyne","year":"2020","unstructured":"Ballantyne CM, Laufs U, Ray KK, Leiter LA, Bays HE, Goldberg AC, et al. Bempedoic acid plus ezetimibe fixed-dose combination in patients with hypercholesterolemia and high CVD risk treated with maximally tolerated statin therapy. Eur J Prev Cardiol. 2020;27(6):593\u2013603.","journal-title":"Eur J Prev Cardiol"},{"key":"3062_CR15","unstructured":"European Medicines Agency. Bempedoic acid. Summary of product characteristics. 2024. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/nilemdo-epar-product-information_en.pdf."},{"key":"3062_CR16","unstructured":"European Medicines Agency. Bempedoic acid\/ezetimibe. Summary of product characteristics. 2024. 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Sci Rep. 2025;15(1):17014.","journal-title":"Sci Rep"}],"container-title":["Lipids in Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12944-026-03062-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12944-026-03062-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12944-026-03062-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:00:45Z","timestamp":1789790445000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12944-026-03062-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3062"],"URL":"https:\/\/doi.org\/10.1186\/s12944-026-03062-6","relation":{},"ISSN":["1476-511X"],"issn-type":[{"value":"1476-511X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]},"assertion":[{"value":"14 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by Ethik-Kommission der Charit\u00e9 - Universit\u00e4tsmedizin Berlin (reference number: EA2\/179\/22) and adhered to the ethical principles outlined in the Declaration of Helsinki and Good Clinical Practice guidelines. The requirement for individual informed consent was waived by the ethics committee because the study used retrospectively collected routine clinical data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare the following financial interests\/personal relationships which may be considered as potential competing interests:L.H. has received an institution grant from Daiichi Sankyo for this manuscript and honoraria for presentations from Daiichi Sankyo. A.B. has received honoraria for presentations from Daiichi Sankyo and has participated on an Advisory Board for Daiichi Sankyo.U.d.R. has received travel support for attending meetings from Amgen.D.S. has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Amgen, Sanofi, Daiichi Sankyo, Novartis and support for attending meetings and\/or travel from Sanofi. D.S. has also participated on a Data Safety Monitoring Board or Advisory Board for Sanofi.J.L.K. has received consulting fees from Daiichi Sankyo and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Daiichi Sankyo, Novartis and Synlab. J.L.K. has received support for attending meetings and\/or travel from Boehringer Ingelheim, Daiichi Sankyo and Eli Lilly. J.L.K. has also participated on a Data Safety Monitoring Board or Advisory Board for Novartis. J.L.K. is a board member of D\u2022A\u2022CH-Gesellschaft Pr\u00e4vention von Herz-Kreislauf-Erkrankungen.S.K. has received payment support from Daiichi Sankyo and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, Daiichi Sankyo, Sanofi, AstraZeneca and Eli Lilly. S.K. has received support for attending meetings and\/or travel from Novartis and AOP.U.S. has received consulting fees from Amgen, Novartis, Sobi and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Amgen, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Novartis, Novo Nordisk, Sanofi Aventis, Sobi and Synlab Holding. U.S. has received support for attending meetings and\/or travel from AstraZeneca, Daiichi Sankyo and Novo Nordisk. U.S. is a board member of the D\u2022A\u2022CH-Gesellschaft Pr\u00e4vention von Herz-Kreislauf-Erkrankungen, Dresdner Herz-Kreislauf-Tage, Saxonian Society of Endocrinology and Metabolism, and a section member of the DAS of German Endocrine Society.K.M. has received an institution grant from Daiichi Sankyo for this manuscript.U.K. has payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Amgen, Daiichi Sankyo, Sobi, Berlin Chemie, Synlab Academy, and Novartis. U.K. has received support for attending meetings and\/or travel from Daiichi Sankyo. U.K. has also participated on a Data Safety Monitoring Board or Advisory Board for Daiichi Sankyo, Berlin Chemie, Sobi, Arrowhead, and Chiesi.T.B. has received an institution grant from Daiichi Sankyo.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"196"}}