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Bempedoic acid

Phase 3

Hypercholesterolemia | Small molecule | Metabolic |Esperion Therapeutics, Inc.|Last Updated: Jul 17, 2026

Success Probability

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials7
Total Enrollment3,008

FDA Designations

No designations recorded

Clinical trial landscape

Bempedoic acid · 8 trials · 5 indications

Phase 3 5Phase 2 3
NCT03067441Assessment of the Long-Term Safety and Efficacy of Bempedoic Acid (CLEAR Harmony OLE)Hypercholesterolemia
COMPLETED1,462 Analytics
NCT02993406Evaluation of Major Cardiovascular Events in Participants With, or at High Risk for, Cardiovascular Disease Who Are Statin Intolerant Treated With Bempedoic Acid (ETC-1002) or PlaceboCardiovascular Diseases
COMPLETED13,970 Analytics
NCT03001076Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) as Add-on to Ezetimibe Therapy in Patients With Elevated LDL-C (CLEAR Tranquility)Hypercholesterolemia
COMPLETED269 Analytics
NCT02991118Evaluation of Long-Term Efficacy of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia at High Cardiovascular RiskHypercholesterolemia
COMPLETED779 Analytics
NCT02988115Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia and Statin IntolerantHypercholesterolemia
COMPLETED345 Analytics
PHASE3COMPLETED
Assessment of the Long-Term Safety and Efficacy of Bempedoic Acid (CLEAR Harmony OLE)
HypercholesterolemiaUnlock trial analytics
PHASE3COMPLETED
Evaluation of Major Cardiovascular Events in Participants With, or at High Risk for, Cardiovascular Disease Who Are Statin Intolerant Treated With Bempedoic Acid (ETC-1002) or Placebo
Cardiovascular DiseasesUnlock trial analytics
PHASE3COMPLETED
Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) as Add-on to Ezetimibe Therapy in Patients With Elevated LDL-C (CLEAR Tranquility)
HypercholesterolemiaUnlock trial analytics
PHASE3COMPLETED
Evaluation of Long-Term Efficacy of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia at High Cardiovascular Risk
HypercholesterolemiaUnlock trial analytics
PHASE3COMPLETED
Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia and Statin Intolerant
HypercholesterolemiaUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Up to Week 82

TEAEs are defined as adverse events that began or worsened in severity after the first dose of investigational medicinal product (IMP) until 30 days after the last dose in the Open-Label Extension (OLE) Study.

Number of Participants With First Occurrence of Four Component Major Adverse Cardiovascular Events (MACE)
Up to 68 months

The primary efficacy end point was a four-component composite of adjudicated MACE, defined as death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization, as assessed in a time-to first-event analysis.

Percent Change From Baseline to Week 12 in Low-Density Lipoprotein Cholesterol (LDL-C)
Week 12

Blood samples were drawn after a minimum 10-hour fast (water was allowed) at pre-specified intervals. Samples were collected and analyzed for LDL-C. Baseline was defined as the mean of the LDL-C values from the last two non-missing values on or prior to Day 1. Percent change from baseline was calculated as: (\[LDL-C value at Week 12 minus Baseline value\] divided by \[Baseline Value\]) multiplied by 100. Bempedoic Acid = BA. Percent change from Baseline in LDL-C was analyzed using an analysis of covariance (ANCOVA) model with percent change from Baseline as the dependent variable, treatment as a fixed effects and Baseline as a covariate. In the ANCOVA model, missing LDL-C data at Week 12 were imputed using multiple imputation method taking into account adherence to treatment.

Percent Change From Baseline (PCFB) in Low-density Lipoprotein Cholesterol (LDL-C) at Week 12
Baseline; Week 12

PCFB was calculated as the (\[post-Baseline (BL) value minus the BL value\] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. PCFB in LDL-C was analyzed using analysis of covariance (ANCOVA), with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.

Observed Trough Plasma Concentration of ETC-1002 Following 8 Weeks of Steady State Dosing of Bempedoic Acid
Week 8 pre-dose

Blood plasma samples were collected and analyzed to determine the plasma trough concentration of ETC-1002 following 8 weeks of steady-state dosing of bempedoic acid. The data presented here is for participants who received tablet formulation only.

Model-based Steady State Area Under the Concentration-time Curve Over 24 Hours (AUC,24ss) of ETC-1002
24 hours

Blood plasma samples were collected and analyzed to determine the AUC,24ss of ETC-1002 over 24 hours. The data presented here is for participants who received tablet formulation only.

Model-based Steady State Average Plasma Concentration (Cavg,ss) of ETC-1002
Week 8, 24 hours post-dose at steady state

Blood plasma samples were collected and analyzed to determine the Cavg,ss of ETC-1002. Cavg was calculated by empirical Bayesian estimated pediatric exposure over 24 hours divided by 24 (AUC24hr.ss / 24). The data presented here is for participants who received tablet formulation only.

Model-based Steady State Maximum Plasma Concentration (Cmax,ss) of ETC-1002
Day 1: 1-hour and 4 hours post-dose; Week 4 pre-dose; Week 8 pre-dose

Blood plasma samples were collected and analyzed to determine the Cmax,ss of ETC-1002. The data presented here is for participants who received tablet formulation only.

Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C) at Month 2
Baseline; Month 2

Percent change from Baseline is calculated as the (\[post-Baseline value minus the Baseline value\] divided by the Baseline value ) x 100. Baseline is defined as the average of the last two non-missing values within Month -1 (Screening Visit 4) and Day 1 (Treatment Visit 1) values (including unscheduled assessments). If only one value was available, then that single value was used at Baseline. Percent change from Baseline was analyzed using analysis of covariance (ANCOVA), with treatment group as a factor and Baseline as a covariate. Missing data were imputed using last observation carried forward (LOCF) (only post-Baseline values were carried forward).

Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C) at Week 6
Baseline; Week 6

Percent change from Baseline is calculated as the (\[post-Baseline value minus the Baseline value\] divided by the Baseline value ) x 100. Baseline is defined as the mean of the values from Week -1 (Screening Visit 2) and predose Day 1/Week 0 (Treatment Visit 1). Percent change from Baseline in LDL-C was analyzed using analysis of covariance (ANCOVA) with treatment group as a factor and Baseline value as a covariate. Missing LDL-C values were imputed using last observation carried forward (LOCF), with only post-Baseline values carried forward. If LDL-C was measured (i.e., if TG was \>400 mg/dL or LDL-C was \<50 mg/dL), the measured values were used in the analysis.

Secondary Endpoints

Percent Change From Parent Study Baseline in Low-Density Lipoprotein Cholesterol (LDL-C) at Weeks 52 and 78
Baseline; Week 52 and Week 78
Mean Change From Parent Study Baseline in LDL-C at Weeks 52 and 78
Baseline; Week 52 and Week 78
Percent Change From Parent Study Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C) at Weeks 52 and 78
Baseline; Week 52 and Week 72
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Open-Label bempedoic acidEXPERIMENTALbempedoic acid 180 mg tablet
Bempedoic Acid 180 mgEXPERIMENTALBempedoic acid 180 mg tablet taken orally, once daily.
Placebo ComparatorPLACEBO_COMPARATORMatching placebo tablet taken orally, once daily
bempedoic acidEXPERIMENTALbempedoic acid 180 mg tablet taken orally, daily. Patients remain on ongoing ezetimibe therapy (study provided)
placeboPLACEBO_COMPARATORMatching placebo tablet taken orally, daily. Patients remain on ongoing ezetimibe therapy (study provided)
Cohort 1EXPERIMENTALParticipants at 16 to \<30 kilograms (kg) body weight at screening receiving once daily 60 milligrams (mg) bempedoic acid for 8 weeks followed by 90 mg bempedoic acid for 8 weeks.
Cohort 2EXPERIMENTALParticipants at 30 to 60 kg body weight at screening receiving once daily120 mg bempedoic acid for 8 weeks followed by 150 mg bempedoic acid for 8 weeks.
Cohort 3EXPERIMENTALParticipants at greater than 60 kg body weight at screening receiving once daily 180 mg bempedoic acid for 8 weeks.
Triplet TherapyEXPERIMENTALBempedoic acid 180 mg, ezetimibe 10 mg, and atorvastatin 20 mg taken orally, daily.

Interventions

NameTypeDescription
bempedoic acidDRUGbempedoic acid 180 mg tablets taken orally, once per day.
Bempedoic acid 180 mg tabletDRUGPatients take bempedoic acid 180 mg tablet orally once daily
Matching placebo tabletDRUGPatients take matching placebo tablet orally once daily
EzetimibeDRUGezetimibe 10 mg tablet
PlaceboOTHERmatching placebo tablet
bempedoic acid 180mgDRUGDaily bempedoic acid 180mg tablet in addition to monthly PCSK9i (evolocumab) background therapy
evolocumabDRUGMonthly PCSK9i (evolocumab) background therapy
Ezetimibe 10mgDRUGezetimibe 10 mg
Atorvastatin 20mgDRUGatorvastatin 20 mg
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites3

Inclusion Criteria: * Successfully completed CLEAR Harmony (1002-040) parent study Exclusion Criteria: * Experienced a treatment-related SAE that led to study drug discontinuation in the CLEAR Harmony (1002-040) parent study. * Medical condition requires lipid measurement and/or adjustment of bac...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaChileColombiaCroatiaCzechiaDenmarkEstoniaGermanyHungaryIndiaLatviaLithuaniaMexicoNetherlandsNew ZealandPolandRomaniaRussiaSerbiaSlovakiaSouth AfricaSpainTurkey (Türkiye)UkraineUnited Kingdom
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Frequently asked questions about Bempedoic acid

What is Bempedoic Acid + Ezetimibe Fixed-Dose Combination used for?

Bempedoic Acid + Ezetimibe Fixed-Dose Combination is an investigational small molecule being developed for hyperlipidemias, hypercholesterolemia, cardiovascular diseases, and diabetes. It is studied in patients with elevated LDL-C, including those on maximally tolerated statin therapy and children with heterozygous familial hypercholesterolemia.

What does Bempedoic Acid + Ezetimibe Fixed-Dose Combination target?

The fixed-dose combination contains bempedoic acid, an ATP citrate lyase inhibitor that reduces cholesterol synthesis in the liver, and ezetimibe, which inhibits intestinal cholesterol absorption. Together they lower LDL cholesterol through complementary mechanisms.

Who makes Bempedoic Acid + Ezetimibe Fixed-Dose Combination?

Bempedoic Acid + Ezetimibe Fixed-Dose Combination is being developed by Esperion Therapeutics, Inc. (NASDAQ: ESPR). The company has conducted multiple clinical trials evaluating the combination for lipid-lowering and cardiovascular outcomes.

What phase is Bempedoic Acid + Ezetimibe Fixed-Dose Combination in?

Bempedoic Acid + Ezetimibe Fixed-Dose Combination is in Phase 3 clinical development. It remains investigational and has not been approved by the FDA. Completed Phase 3 trials include a cardiovascular outcomes study and a study comparing the combination to its individual components.

What clinical trials is Bempedoic Acid + Ezetimibe Fixed-Dose Combination in?

Completed trials include NCT02993406, a Phase 3 cardiovascular outcomes study in statin-intolerant patients; NCT03337308, a Phase 3 study of the fixed-dose combination versus bempedoic acid, ezetimibe, and placebo; and NCT03051100, a Phase 2 triplet therapy study. All seven trials are completed.

Is Bempedoic Acid + Ezetimibe Fixed-Dose Combination the same as ETC-1002?

Bempedoic Acid + Ezetimibe Fixed-Dose Combination contains bempedoic acid, which is also known as ETC-1002. Clinical trials reference ETC-1002 as the bempedoic acid component, while the fixed-dose combination adds ezetimibe to this active ingredient.