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NICE recommends bempedoic acid with ezetimibe to treat high cholesterol

Thousands of NHS patients who have high cholesterol in their blood will now be able to access a new treatment option outside of statin.

In a new guidance published on Wednesday (April 28), NICE has recommended bempedoic acid with ezetimibe as an option for treating primary hypercholesterolaemia or mixed dyslipidaemia in patients for whom statins are contraindicated or not tolerated, and ezetimibe alone does not control lipoprotein cholesterol well enough.


The National Institute for Health and Care Excellence’s (NICE) latest recommendation is expected to benefit around 70,000 adults in England. Current standard treatment for high cholesterol includes dietary changes and statins for lowering low‑density lipoprotein cholesterol (LDL-C) levels.

People may also be treated with ezetimibe and either alirocumab or evolocumab when their cholesterol levels are not lowered enough with the maximally tolerated dose of statins.

The new NICE guidance means bempedoic acid with ezetimibe will be offered as an option for people who are unable to use statins and whose high cholesterol is not well-controlled with ezetimibe alone.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: “High cholesterol, if left untreated, can lead to a range of serious health conditions. Although statins and other treatments are used successfully by a large portion of the population, some people may require other options to control their cholesterol.

“We are pleased to be able to recommend bempedoic acid with ezetimibe as a new treatment option for these individuals.”

“Bempedoic acid with ezetimibe are both taken once daily in tablet form. They can be used as separate tablets (Nilemdo by Daiichi Sankyo, plus ezetimibe) or in a fixed-dose combination (Nustendi by Daiichi Sankyo),” the NICE said.

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