Since this process is restricted to the liver, this explains the low myalgia symptoms reported in patients taking bempedoic acid.46 The CLEAR Harmony trial included patients with ASCVD with or without heterozygous familial hypercholesterolemia, who were randomized into two groups: bempedoic acid and placebo.47 The bempedoic acid group had LDL-C levels reduced by 16.5% from baseline in addition to the 12% reduction in apolipoprotein B, confirming its efficacy and safety as an adjunct to statin therapy regardless of the statin dose. This evidence concerns the gene APOB and familial hypercholesterolemia.