D3.260 - Bempedoic acid allergy in a patient with hypercholesterolemia
Background
Bempedoic acid is a novel ATP citrate lyase inhibitor used for hypercholesterolemia, particularly in patients intolerant to statins and other lipid-lowering therapies. While commonly associated with gastrointestinal and musculoskeletal side effects, hypersensitivity reactions are rarely reported.We report a case of confirmed allergy to bempedoic acid.
Method
Case report -A 71-year-old woman with hypercholesterolemia, intolerant to statins, fibrates, and ezetimibe due to acid reflux, was started on bempedoic acid by her lipid clinic team. At home, three hours after the first dose, she developed generalized urticaria, which resolved with antihistamines. She had previously stopped evolocumab due to suspected hives, though symptoms persisted after discontinuation. To confirm bempedoic acid hypersensitivity, a supervised drug provocation test with 180 mg was performed.
Results
During drug provocation test, the patient developed pruritus and erythema within 45 minutes, followed by urticaria. Symptoms were managed with antihistamines, confirming type I hypersensitivity to bempedoic acid.
Conclusion
Our case illustrates a confirmed hypersensitivity reaction to bempedoic acid.While bempedoic acid may offer a therapeutic alternative for some statin-intolerant patients, this case highlights the potential for allergic reactions. Given the limited number of cases reported in the literature, further research is essential to better understand the safety profile and potential allergic reactions associated with bempedoic acid in statin-intolerant individuals.
