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Fenofibrate slows diabetic retinopathy progression in at-risk patients
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Intensive treatment of glycemia and dyslipidemia slowed the progression of diabetic retinopathy in diabetic patients with cardiovascular disease or associated risk factors, according to study findings.
Data were culled from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, a collection of three randomized clinical trials designed to evaluate the effects of intensive blood glucose and blood pressure control and a combination of fenofibrate and statin vs. statin monotherapy therapy for dyslipidemia on the incidence of cardiovascular disease in patients with type 2 diabetes.
Researchers analyzed data from 2,856 patients. Eye examinations and fundus photography were conducted at baseline and at 4 years.
In the glycemia trial, the target of intensive treatment was hemoglobin A1c of less than 6% and the target of standard treatment was hemoglobin A1c of 7% to 9%.
In the blood pressure trial, the target of standard treatment was systolic blood pressure of less than 120 mm Hg and the target of intensive treatment was blood pressure of less than 140 mm Hg.
In the dyslipidemia trial, the researchers compared fenofibrate plus simvastatin with placebo plus simvastatin.
The researchers found that patients who received intensive glycemia and dyslipidemia treatment experienced statistically significant benefit, whereas no benefit was experienced from intensive blood pressure control.
Specifically, progression of retinopathy was slowed significantly among patients with a mean age of 62 years and mean diabetes duration of 10 years who had cardiovascular disease or cardiovascular risk factors and who underwent intensive glycemia treatment; however, the effects did not reach significance in patients with no retinopathy or in those with moderate to severe retinopathy, according to the researchers.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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