Study shows fenofibrate reduces need for laser treatment for diabetic retinopathy

November 05, 2007

Treatment with fenofibrate in individuals with type 2 diabetes mellitus reduces the need for laser treatment for diabetic retinopathy (DR), conclude authors of an Article published early Online and in a upcoming edition of The Lancet.

DR has become the leading cause of vision loss and blindness in working-age adults in both developed and developing countries. Pathological changes associated with the condition are strongly related to hyperglycamia in type 2 diabetes. Visual loss results mainly from central macular oedema, and less frequently from proliferative DR.

Professor Tony Keech, NHMRC Clinical Trials Centre, University of Sydney, NSW, Australia, and colleagues from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study did a trial of 9795 patients aged 50-75 years, each with type 2 diabetes mellitus. Eligible patients were randomly assigned to receive fenofibrate 200 mg /day or matching placebo. At each clinic visit, information concerning laser treatment for DR was gathered. In a substudy of 1012 patients, standardised retinal photography was done and photographs were graded with Early Treatment Diabetic Retinopathy Study (ETDRS) criteria to determine the cumulative incidence of DR and its component lesions.

The researchers found that, with an average follow-up of five years, fenofibrate reduced the frequency of first laser treatment for macular oedema by 31% and for proliferative DR by 30%. In the substudy, the fenofibrate reduced the risk of first laser treatment by more than 70%; however the actual number of events was small (23 surgeries in the placebo group versus five in the fenofibrate group).

Fenofibrate is a lipid-modifying agent; yet it did not lead to clinically important differences in HDL-cholesterol concentrations between the fenofibrate group and the placebo group. The authors say: "These findings suggest that the mechanisms of benefit of fenofibrate in diabetic retinopathy must go beyond the effects of this drug on lipid concentrations or to lower blood pressure, and might be conferred mainly by other means."

They conclude: "The substantial benefits of fenofibrate on need for laser treatment for diabetic retinopathy are likely to be additive to those benefits arising from tight control of blood glucose and blood pressure in the management of type 2 diabetes mellitus, and emerge rapidly after treatment is commenced. The retinal benefits argue for consideration of using fenofibrate in the management of diabetic eye disease, and should be considered in the context of other effects reported with fenofibrate in the FIELD study."

In an accompanying Comment, Dr Rafael Simo and Dr Cristina Hernandez, Diabetes Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain, say: "The mechanisms by which fenofibrate exerts its reported benefits are far from being elucidated -- further clinical and experimental studies are needed before fenofibrate can be launched as a new tool in the management of diabetic retinopathy."
-end-
Professor Tony Keech, NHMRC Clinical Trials Centre, University of Sydney, NSW, Australia, T) +61 414 625 004 E) tony@ctc.usyd.edu.au

Dr Rafael Simo, Diabetes Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain T) +34 93 4894172/ 609589733 E) rsimo@ir.vhebron.net

Lancet

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.