Esperion’s Bempedoic Acid Receives Multiple Class 1 Recommendations in 2026 ACC/AHA Multisociety Guideline for Management of Dyslipidemia

Core Insights - Bempedoic acid has received strong endorsement from the AHA/ACC Multisociety Guideline for patients with statin intolerance and severe hypercholesterolemia, positioning it alongside PCSK9 mAb and ezetimibe for high-risk primary prevention and clinical ASCVD patients not at very high risk [1][2] - The guideline emphasizes the importance of early combination lipid-lowering therapy and reintroduces LDL-C goals, supporting the 'lower for longer is better' approach to cardiovascular risk reduction [1][5] Summary of Recommendations - Class 1 recommendations indicate that adults without a history of clinical ASCVD who experience statin-attributed muscle symptoms and are at high ASCVD risk should add bempedoic acid and/or ezetimibe to lower LDL-C to <70 mg/dL and non-HDL-C <100 mg/dL [3] - For adults with clinical ASCVD experiencing statin-attributed muscle symptoms, a reduced statin dose and the addition of bempedoic acid, ezetimibe, or a PCSK9 mAb are recommended to lower LDL-C and reduce ASCVD risk [3] - In adults with diabetes who have statin-attributed side effects, initiation of ezetimibe and/or bempedoic acid or a PCSK9 mAb is recommended to lower LDL-C and reduce ASCVD risk [3] - For adults with severe hypercholesterolemia on maximally tolerated statin therapy, the addition of ezetimibe, a PCSK9 mAb, and/or bempedoic acid is recommended to achieve LDL-C goals and reduce ASCVD risk [3] - Class 2a recommendations suggest that for adults with clinical ASCVD not at very high risk, it is reasonable to add bempedoic acid, ezetimibe, or a PCSK9 mAb to achieve LDL-C <70 mg/dL and non-HDL-C <100 mg/dL [3][7] Company Positioning - Esperion views the guideline recognition as a significant milestone that validates bempedoic acid as an evidence-based therapy for patients requiring additional LDL-C lowering or unable to tolerate statins, which strengthens its market position [2] - The endorsement is expected to accelerate the adoption and expand access to Esperion's products, NEXLETOL (bempedoic acid) and NEXLIZET (bempedoic acid and ezetimibe) [2][10]