Can fenofibrate therapy reduce the need for retinal laser treatment in patients with diabetic eye disease?

This review evaluated the effect of prolonged fenofibrate (Tricor) treatment on the need for retinal laser treatment for diabetic eye disease in patients with type 2 diabetes (T2D). The data showed a reduced need for retinal laser treatment in these patients compared to placebo.

Diabetic eye disease refers to eye conditions that occur in patients with diabetes. These conditions can lead to poor vision and blindness. The retina is the inner lining located at the back of the eyes that senses light. Weakened, damaged, bulging, leaky or abnormal blood vessels in the retina are known as diabetic retinopathy (DR), a type of diabetic eye disease. Another type of eye disease is diabetic maculopathy (DM), caused by swelling of the area of the retina required for reading and visualizing fine details (macula).

Medical management of diabetic eye disease promotes risk factor control of high blood glucose, high blood pressure and elevated levels of cholesterol and triglycerides (fat-like substances called lipids). Another treatment option is retinal laser treatment that uses a light beam to shrink abnormal blood vessels.

Fenofibrate is an oral medication used to reduce high lipid levels. It has been suggested that prolonged fenofibrate therapy may reduce the need for retinal laser treatment in these patients. However, clinical trial data are limited and the effect of prolonged fenofibrate treatment remains unclear.

This review analyzed the results of 3 randomized, placebo-controlled trials that included patients with T2D. 892 patients had received retinal laser treatment. 391 patients that received fenofibrate had laser treatment. 501 patients that had placebo received laser treatment. Lipid changes at 1 year and first laser treatment for DR and DM were determined. The follow-up period was 1 year.

On average, patients treated with fenofibrate had a 20% to 30% reduction in triglycerides, a 3% to 12% reduction in total cholesterol, and 0% to 12% reduction in low-density lipoprotein (LDL; "bad") cholesterol compared to patients that had placebo.

There was a 23% lower odds of laser eye treatment in patients treated with fenofibrate compared to those treated with placebo.

The study suggested that patients with T2D treated with fenofibrate had a lowere need for retinal laser treatment for diabetic eye disease compared to those given placebo.

This review included some unpublished reports since studies are limited and preliminary. Additionally, more in-depth studies are needed.