Health · Pharma & Biotech · 1 day ago
Non-statin drugs offer options for lowering LDL cholesterol
People who cannot tolerate statins, or whose LDL cholesterol stays above their target while taking them, may need another treatment.
Statins remain the standard treatment for people who can take them, while alternatives may be used instead or alongside them.
Three non-statin options have evidence of reducing heart attacks and strokes, but the evidence comes from different groups and treatment combinations.
Ezetimibe lowers LDL by about 18% on its own, while its strongest evidence on cardiovascular events is for use with a statin.
Bempedoic acid reduced major events in a study of people who could not tolerate statins and had cardiovascular disease or high risk, though nearly one in four also took a statin.
Anti-PCSK9 injections lowered LDL by 45% to 64% and reduced events in high-risk patients, mostly when added to existing treatment.
The choice depends on a person's cardiovascular risk, how much LDL needs to fall and how they tolerate treatment, so a doctor should assess statin intolerance before any changes are made.
Non-statin drugs can lower LDL cholesterol when statins are not tolerated or do not bring levels to target.
Three non-statin treatments have evidence of reducing heart attacks and strokes, but the evidence comes from different patient groups and treatment settings.
Ezetimibe lowers LDL by about 18% when used alone, while the PCSK9 drugs evolocumab and alirocumab lower it by about 45% to 64%.
Bempedoic acid reduced major cardiovascular events in a study of people who could not tolerate statins, but it did not significantly reduce mortality on its own.
Statins remain the reference treatment for people who can take them, and treatment choices should be made with a doctor.
- Who
- People who cannot tolerate statins or whose LDL remains above target while taking them.
- What
- The article describes non-statin options for lowering LDL and evidence that some reduce cardiovascular events.
- When
- The article was published on October 13, 2026.
- Where
- Not stated.
- Why
- These treatments may be used when statins are not tolerated or do not lower LDL enough.
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- Ezetimibe
- Lowers LDL by about 18% when used alone.
- Bempedoic acid study
- 13,970 people who could not tolerate statins.
- Major events in bempedoic acid study
- 11.7% of treated participants versus 13.3% given placebo.
- PCSK9 drugs
- Evolocumab and alirocumab lower LDL by about 45% to 64%.
- European recommendations
- 2025 recommendations include therapies with proven cardiovascular benefit for people unable to take statins.