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Fenofibrate cut adverse CV outcomes in women with diabetes by one-third
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Women with type 2 diabetes who are at risk for heart disease had a 30% reduction in adverse cardiovascular outcomes with the cholesterol-lowering drug fenofibrate, according to research published in Diabetologia.
Treatment with fenofibrate also demonstrated a 24% decrease in adverse outcomes among men with type 2 diabetes, providing reassurance that the therapy could offer cardioprotection for both sexes, according to Australian researchers.
Michael C. d’Emden, MD, of the Endocrine Research Unit at Royal Brisbane Hospital and the University of Queensland in Brisbane, and colleagues from other institutions, looked at 9,795 adults (3,657 women and 6,138 men) with type 2 diabetes and not using statins from the double-blind placebo-controlled Fenofibrate Intervention and Event Lowering in Diabetes trial.
Michael C. d’Emden
Patients were treated with fenofibrate (200 mg/day) or placebo over 5 years. The researchers evaluated effects on lipoproteins and total CV events by sex.
At baseline, total cholesterol, LDL-, HDL- and non-HDL cholesterol and apolipoproteins A-I and B differed between sexes; these improved with fenofibrate in both sexes, along with triacylglycerol levels (all P<.001).
Fenofibrate reduced total cholesterol, LDL- and non-HDL cholesterol and apolipoprotein B more in women (all P<.001); this was independent of menopausal status and statin uptake.
With fenofibrate, total cardiovascular outcomes including CV death, fatal and non-fatal stroke and carotid and coronary revascularization dropped by 30% in women (P=.008) and 13% in men (P=.07), adjusting for covariates. There was no treatment-by-sex interaction (P>.01).
Women with high triacylglycerol levels and low HDL-cholesterol demonstrated a 30% (95% CI, −7% to 54%) decrease in CV outcomes and men a 24% (95% CI, 2% to 42%) decrease, with no treatment-by-sex interaction (P>.1).
“These results suggest that fenofibrate is effective for improving an adverse lipoprotein profile and for reducing total CVD event risk in women with type 2 diabetes, especially those with dyslipidemia,” the researchers wrote.
Disclosures: FIELD was supported by a grant from Laboratoires Fournier, Dijon, France (now part of Abbott Pharmaceuticals) and the National Health and Medical Research Council of Australia. Some researchers report receiving speaker’s bureau fees, and travel and/or research grants from Solvay (now Abbott Pharmaceuticals).
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