Three months of bempedoic acid treatment does not affect cystatin C–based estimation of glomerular filtration rate

Introduction: Bempedoic acid can interfere with creatinine excretion, thereby potentially altering the calculation of glomerular filtration rate (eGFR), but is not known to have an effect on cystatin C metabolism. Aim: The aim of this pilot observational study was to assess the impact of 3-months bempedoic acid treatment on renal function assessed by serum creatinine and cystatin C. Methods: Consecutive hypercholesterolemic outpatients with indication to be started on bempedoic acid and available serum creatinine and cystatin C levels were enrolled. Follow-up (45–90 days) renal function markers were assessed. Lipid profile, uric acid levels, and CRP levels were also recorded. Results: Bempedoic acid reduced LDL-c and total cholesterol levels by day 45. No changes were observed in HDL-c, triglycerides, Lp(a), serum creatinine, eGFRcr, BUN, uric acid, or CRP levels throughout the study. The sensitivity analysis on individuals with complete data for cystatin C during follow-up (42%) confirmed the overall observations, while also showing neutral effects of bempedoic acid eGFRcys and eGFRcr-cys. Conclusions: Three-months administration of bempedoic acid did not affect cystatin C levels. Adequately powered studies are needed to test these findings and, ultimately, the renal safety of bempedoic acid.