The use of fenofibrate may be instrumental in reducing the risk of progression to vision-threatening diabetic retinopathy (VTDR). According to the findings of a recent study published in JAMA Ophthalmology, the use of fenofibrate was linked to a reduced risk of progression from non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR) and vision-threatening diabetic retinopathy (VTDR). However, its effect in cases of diabetic macular edema (DME) alone is yet to be ascertained.
The multicentre study used data from a large US insurer and Cohorts were created from all patients with NPDR 18 years or older who had laboratory values from January 1, 2002, to June 30, 2019. Patients with existing or previous diagnoses of PDR, DME, proliferative vitreoretinopathy, or treatment used in the care of VTDR were kept out of the study. A total of 5835 fenofibrate users and 1,44, 417 fenofibrate nonusers were analysed for the study.
Of the total sample size 27 325 (18.2%) progressed to VTDR, 4086 (2.71%) progressed to PDR, and 22 750 (15.1%) progressed to DME. The Cox model results after controlling for all covarities showed fenofibrates to be associated with a decreased risk of VTDR (hazard ratio, 0.92 [95% CI, 0.87-0.98]; P = .01) and PDR (hazard ratio, 0.76 [95% CI, 0.64-0.90]; P = .001) but not DME (hazard ratio, 0.96 [95% CI, 0.90-1.03]; P = .27).
The study’s lead author Brian L. VanderBeek of the Scheie Eye Institute wrote that the findings add new information with regards to the impact on DME over the existing results of previous clinical trials.
More clinical trials may be needed to conclude that the association are representative of a causal relationship between the use of fenofibrate and a drop in the risk factor
While previous studies had pointed to reduced progression of diabetic retinopathy severity, they failed to conclusively address the thresholds of DME or PDR. In comparison, the recent pointed to reduced laser treatment of DME and PDR with the use of fenofibrate. Though in terms of the overall progression of diabetic retinopathy, the findings churned out mixed results.
The results have evoked fresh interest in analyzing the potential role of fenofibrate in diabetic retinopathy care and several clinical trials are being conducted to reach a more conclusive result.
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