Coenzyme Q10 mitigates Bempedoic Acid-induced hyperuricemia in hyperlipidemic rats

Background and objective: Hyperlipidemia is a key risk factor for atherosclerotic cardiovascular disease (ASCVD). Bempedoic Acid (BA) is an ATP-citrate lyase inhibitor indicated for statin-intolerant patients, or patients at high risk of ASCVD with hyperlipidemia. However, BA may raise plasma uric acid levels, potentially causing hyperuricemia and gout. Coenzyme Q10 (CoQ10), a natural antioxidant, has anti-inflammatory and renal-protective properties. This study evaluates CoQ10's potential to mitigate BA-induced renal side effects in a hyperlipidemic rat model. Methods: Forty male Sprague-Dawley rats were divided into five groups: a negative control (normal), a positive control (hyperlipidemic), a BA-treated group (hyperlipidemic rats on BA monotherapy),a BA + CoQ10 group (hyperlipidemic rats receiving BA and CoQ10 combination), and a BA + Allopurinol group (hyperlipidemic rats receiving BA and Allopurinol combination). The positive control and all treatment groups received a high-fat diet to induce and maintain hyperlipidemia throughout the experiment. After 8 weeks of inducing hyperlipidemia, therapeutic interventions were administered for a further 10 weeks. Renal biomarkers (uric acid, serum creatinine, and blood urea nitrogen) and the oxidative stress biomarker malondialdehyde (MDA) were measured. Results: BA monotherapy significantly raised mean serum uric acid and creatinine compared with the negative control group. Co-administration of CoQ10 significantly lowered both parameters. Mean serum MDA was significantly reduced in all treatment groups compared with the positive control group. Conclusion: These findings suggest that combining BA with CoQ10 could serve as a therapeutic strategy for hyperlipidemic patients on BA therapy who have compromised renal function.