CLEAR Outcomes Trial
New England Journal of Medicine (2023)
13% MACE reduction (HR 0.87) in 13,970 statin-intolerant patients over 40.6 months.
How it works
Marek's Guided Optimization® Program combines advanced lab testing, a dedicated health coach and medical provider, and a personalized treatment plan, all built around your data.
Resources
The process
1
Start your assessment
Complete your 45-min intake assessment
2
Get your labs drawn
4,000 partnered lab locations nationwide
3
Review with your coach
Screen-by-screen lab review
4
Receive your protocol
Treatment delivered to your door
Why Marek
The only program pairing you with a dedicated health coach and medical provider, built on precision diagnostics, with no subscription required.
Resources
Meet our co-founder
Derek
Co-Founder · MPMD Podcast
"Over time, I found it incredibly difficult to get medical oversight for myself and my family that reflected the latest research, and that was preventative. That's why I started Marek Health."
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What we test
Every client's lab panel is hand-selected from 1,000+ available biomarkers, built around their specific goals.
Panel categories
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Treatments
700+ medical provider-prescribed therapies built from your labs. Browse by category or explore the full formulary.
Bempedoic Acid (Nexletol)
Oral tablet (180mg)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
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Bempedoic Acid (Nexletol)Bempedoic Acid (Nexletol)
First-in-class oral ATP-citrate lyase inhibitor that reduces cholesterol synthesis upstream of HMG-CoA reductase. Liver-specific activation (via ACSVL1) means no myopathy, critical advantage for statin-intolerant patients. CLEAR Outcomes showed 13% MACE reduction.
No myopathy (muscle lacks activating enzyme)
17 to 25% LDL reduction (38% combined with ezetimibe)
CLEAR Outcomes: 13% MACE reduction
Oral once-daily tablet
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Prodrug activated by hepatic ACSVL1 (absent in skeletal muscle) to inhibit ATP-citrate lyase, reducing acetyl-CoA supply for cholesterol synthesis. Liver-selective mechanism eliminates statin-associated muscle toxicity.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Bempedoic Acid (Nexletol).
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Hyperuricemia and gout
- Upper respiratory infections
- Muscle spasms
- Elevated transaminases
Less common but serious risks
- Tendon rupture (FDA warning)
- Gout exacerbation
- Drug interaction: raises simvastatin/pravastatin levels
Generally not appropriate for
- Simvastatin >20mg or pravastatin >40mg
- Active gout (relative)
- Pregnancy
Typical monitoring
- Lipid panel
- Serum uric acid
- Liver function
- Tendon symptoms
- Gout symptoms
FAQ
Quick answers.
First-in-class oral ATP-citrate lyase inhibitor that reduces cholesterol synthesis upstream of HMG-CoA reductase. Liver-specific activation (via ACSVL1) means no myopathy, critical advantage for statin-intolerant patients. CLEAR Outcomes showed 13% MACE reduction.
No myopathy (muscle lacks activating enzyme). 17 to 25% LDL reduction (38% combined with ezetimibe). CLEAR Outcomes: 13% MACE reduction. Oral once-daily tablet.
Common side effects include: hyperuricemia and gout, upper respiratory infections, muscle spasms, elevated transaminases. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
First-in-class oral ATP-citrate lyase inhibitor that reduces cholesterol synthesis upstream of HMG-CoA reductase. Liver-specific activation (via ACSVL1) means no myopathy, critical advantage for statin-intolerant patients. CLEAR Outcomes showed 13% MACE reduction.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.