611 W. Union Street
Benson, AZ 85602
(520) 586-0800

Health Choice Integrated Care crisis Line
1-877-756-4090

AzCH Nurse Assist Line
1-866-495-6735

NAZCARE Warm Line
1-888-404-5530



SEABHS
611 W. Union Street
Benson, AZ 85602
(520) 586-0800

AzCH Nurse Assist Line
1-866-495-6735

NAZCARE Warm Line
1-888-404-5530


powered by centersite dot net

Getting Started
Here are some forms to get started. These can be printed and brought with you so that you can pre-fill out some known info ahead of time. More...


Medical Disorders
Resources
Basic InformationLookupsLatest News
AHA News: Culture, Paycheck, Neighborhood Key to Your Heart's HealthDrug Combo Does Double Duty Against Common Skin Lesions, CancersBe Prepared to Take FAST Action If You Suspect a StrokeHeart Risks Vary Among Asian-AmericansAHA News: Emphysema May Raise Risk of Ruptured AneurysmsNew Facial Bone Might Someday Be Grown From the Patient's RibWhat Works Best for Women Struggling With a Leaky Bladder?Your Apple Watch Might Help Spot a Dangerous Irregular HeartbeatDocs Back Away From Low-Dose Aspirin for Heart Attack PreventionAHA News: Overweight Kids at Higher Risk for Blood Clots as AdultsEbola Survivors Continue to Suffer Years After RecoveryFewer Boys Are Suffering Head Injuries, But Rate Rises for GirlsAHA News: Black Woman in Their 50s Face Especially High Stroke RiskNew Drug Could Help Those With Tough-to-Treat CholesterolWhen Can Kids Return to Play After a Concussion?Need to Be Vaccinated? Try Your Local PharmacyOne-Third of U.S. Kids Have Back Pain, Study SaysBlacks, Hispanics Bear Burden of Air Pollution: StudyChickens Help Scientists Pinpoint Origin of Rare, Deadly VirusDry Eye and Migraines Might Be Linked: StudySkin Fungi May Be Tied to Bowel DiseaseYo-Yo Dieting Can Take a Toll on Your HeartAHA News: Opioid Meds Pose Danger to Kidney Disease PatientsHealth Tip: UTI Warning SignsStaph Infections Drop, but Levels Still Worry U.S. Health OfficialsTreatment May Allow Allergic Kids to Eat Eggs Safely: StudyAcne Drug Accutane May Not Depress Mood After AllHealth Tip: Preventing Carpal TunnelMajor Flooding Can Bring Skin Infection DangersSmall Trial Provides New Hope Against Parkinson's DiseaseIs Your Hand Pain Arthritis, Carpal Tunnel or Something Else?California Parents Are Getting Around Vaccine Law, Fueling Measles OutbreaksSeniors With UTIs Need Antibiotics ASAP, Study SaysWhy Do Some Kids With Eczema Develop Food Allergies?High-Fiber Diet May Help Gut 'Microbiome' Battle MelanomaTick Bites More Likely to Cause Red Meat Allergy Than ThoughtWalking, Not Riding, Boosts Health in Golfers With Knee WoesIs At-Home Stool Test a Viable Alternative to Colonoscopy?After Peanut Allergy Rx, Eating Small Bits of Peanut Might Help: StudyA Hard Look at Smoking's Effect on VisionPeanut Allergy Patch Shows Middling Results in TrialToxins in Home Furnishings Can Be Passed on to KidsKratom-Related Poisonings Are Soaring, Study FindsFDA Aims to Strengthen Sunscreen RulesBrain Condition CTE Seen in H.S. Football Players: StudyPregnant Women Should Delay Gallbladder Surgery, Study FindsGut Microbes May Help Drive Lupus, Study FindsMost Hip, Knee Replacements Last Decades, Study FindsAHA News: Living Near Convenience Stores Could Raise Risk of Artery-Clogging ConditionPossible Parkinson's 'Pandemic' Looms: Report
Questions and AnswersLinksBook Reviews
Related Topics

Cancer
Men's Health
Women's Health

New Drug Could Help Those With Tough-to-Treat Cholesterol

HealthDay News
by By Dennis Thompson
HealthDay Reporter
Updated: Mar 14th 2019

new article illustration

THURSDAY, March 14, 2019 (HealthDay News) -- People whose high cholesterol is resistant to treatment with statin drugs may soon have a new treatment option.

This new class of drugs helps block synthesis of artery-clogging cholesterol, researchers explained. The drugs target an enzyme called ATP citrate lyase (ACL), part of the production pathway for "bad" LDL cholesterol in the body.

In the new trial, bempedoic acid, a pill that blocks ACL, reduced LDL cholesterol levels significantly when added to standard statin therapy.

The addition of bempedoic acid on top of a statin drug showed "a much greater reduction in LDL-C than what would be expected simply by increasing the dose of statin therapy," said study author Dr. Brian Ference. He directs translational therapeutics research at the University of Cambridge in England.

His team published its findings in the March 14 issue of The New England Journal of Medicine.

But experts aren't certain how useful bempedoic acid might be, given the wide cholesterol-lowering arsenal now available to heart doctors.

The clinical trial results represent "a rather modest reduction as compared to statins, which lower LDL cholesterol concentrations on average by 20 to 30 percent, and newer drugs such as PCSK9 inhibitors, which can lower LDL cholesterol concentrations by over 50 percent," said Dr. Michael Holmes. He's an associate professor at the University of Oxford in England, and wrote an editorial accompanying the study.

Bempedoic acid also doesn't appear to outperform ezetimibe (Zetia), a drug already on the market, said Dr. Robert Eckel, who holds an endowed chair in atherosclerosis at the University of Colorado School of Medicine in Aurora.

An earlier clinical trial has shown that combining bempedoic acid and ezetimibe lowered LDL cholesterol by about 28 percent more than placebo, said Eckel, an expert with the American Heart Association who was not involved with the new study.

"It suggests that adding ezetimibe, which is typically an 18 to 20 percent reduction, to bempedoic acid only produces a modest additional benefit," Eckel said. "It's not like the 40 percent you would expect."

The body uses ACL further upstream in the same cholesterol synthesis process that also employs the enzyme targeted by statins, known as HMGCR, researchers said in background notes.

A study of nearly 655,000 people found that people's ACL and HMGCR scores were associated with similar patterns in LDL cholesterol levels and similar effects on heart disease risk based on those levels, researchers reported. Ference led this study.

Further, people who carry genetic variants that inhibit ACL have lower LDL cholesterol levels and lower risk of heart health problems, researchers found.

Based on this, researchers decided to test how well a drug that blocks ACL would lower cholesterol levels in average people.

That drug, bempedoic acid, was randomly assigned to 1,488 people with high LDL cholesterol despite being on high-intensity statin therapy. Another 742 statin users were given a placebo.

After a year, bempedoic acid lowered LDL cholesterol levels by 18 percentage points, researchers found.

The most troubling adverse event was the incidence of gout, which led 18 bempedoic acid patients to quit the trial, compared to three placebo patients, Holmes and Eckel said.

Gout occurs when uric acid levels rise in the bloodstream beyond the kidneys' ability to remove the harmful byproduct. High uric acid levels cause crystals to form in joints, producing inflammation and arthritis.

"This discontinuation because of gout is something that needs to be explored further by additional study," Eckel said. "That could end up to be something on the package insert that could influence prescribing patterns."

For example, bempedoic acid might not be best prescribed to people with gout or with already elevated uric acid levels, he said.

The American Heart Association/American College of Cardiology's updated cholesterol treatment guidelines in 2018 kept the main focus on statins, which are cheap and proven effective.

But the AHA and ACC also allowed that ezetimibe and PCSK9 inhibitors could play a role for people whose cholesterol remains elevated despite statin therapy.

"In the setting of patients at high risk of disease who are on maximal doses of statins, additional lipid-lowering drugs will lead to a further reduction in cardiovascular disease risk, as we have seen with PCSK9 inhibitors," said Holmes.

"There is therefore a potential role for drugs that inhibit ACL, such as bempedoic acid, in the treatment and prevention of cardiovascular disease," he said.

More information

The American Heart Association has more about cholesterol medications.