NEJM Evid

ADA 2024: Fenofibrate may reduce progression of diabetic retinopathy

June 25, 2024

Fenofibrate, a drug used to reduce blood lipid levels, reduced progression of diabetic retinopathy compared with placebo among participants with early retinal changes, according to findings from the Lowering Events in Non-proliferative retinopathy in Scotland (LENS) trial. This is the first large-scale trial designed to investigate the effect of fenofibrate on eye outcomes in people with early diabetic retinopathy.

• Researchers recruited and followed 1,151 adults with nonreferable diabetic retinopathy or maculopathy using the national Diabetic Eye Screening (DES) program in Scotland. Participants were randomly assigned to receive 145-mg fenofibrate tablets (n=576) or placebo (n=575). Primary outcome was a composite of developing referable diabetic retinopathy or maculopathy or treatment for retinopathy or maculopathy.
• Over four years, progression to referable diabetic retinopathy or maculopathy, or treatment thereof, occurred in 22.7% of participants in the fenofibrate group and 29.2% in the placebo group (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.58 – 0.91; P=0.006).
• In the fenofibrate group compared with the placebo group, the frequencies for any progression of retinopathy or maculopathy were 32.1% vs. 40.2% (HR, 0.74; 95% CI, 0.61 – 0.90) and for the development of macular edema were 3.8% vs. 7.5% (HR, 0.50; 95% CI, 0.30 – 0.84).

Sources:

(2024, June 21). Common cholesterol-lowering drug found to slow vision loss in diabetes patients. [Press release]. American Diabetes Association. https://diabetes.org/newsroom/press-releases/common-cholesterol-lowering-drug-found-slow-vision-loss-diabetes-patients

Preiss D, et al. (2024, June 21). NEJM Evid. Effect of Fenofibrate on Progression of Diabetic Retinopathy. https://pubmed.ncbi.nlm.nih.gov/38905569/