NEJM Evid
Cholesterol drug fenofibrate trialed for diabetic retinopathy progression
Fenofibrate reduced diabetic retinopathy progression compared with placebo in adults with early retinal changes in this 4-year randomized trial.
- In this RCT, 1,151 adults with nonreferable diabetic retinopathy or maculopathy in Scotland were randomly assigned to 145 mg fenofibrate (daily, or QOD if renal impairment) or placebo. Primary outcome was a composite of referable diabetic retinopathy/maculopathy development or treatment (intravitreal injection, retinal laser, vitrectomy).
- After a median of 4 years, progression to referable diabetic retinopathy/maculopathy, or treatment for these, occurred in 22.7% of the fenofibrate group vs. 29.2% of the placebo group (hazard ratio [HR], 0.73; p=0.006). The frequency of retinopathy/maculopathy progression was 32.1% vs. 40.2% (HR, 0.74), and macular edema development was 3.8% vs. 7.5% (HR, 0.50). There were no effects on visual acuity, visual function, or quality of life.
- The estimated glomerular filtration rate was 7.9 mL/min/1.73 m^2 lower in fenofibrate group than in the placebo group. Serious adverse events occurred in 36.1% of fenofibrate patients vs. 35.5% of placebo patients.
Source:
Preiss D, et al. (2024, August). NEJM Evid. Effect of Fenofibrate on Progression of Diabetic Retinopathy. https://pubmed.ncbi.nlm.nih.gov/38905569/