More Evidence That Fenofibrate Slows Diabetic Eye Disease
Use of the cholesterol-lowering drug fenofibrate had a modest but statistically significant association with reduced risk of vision-threatening diabetic retinopathy (VTDR). For the composite endpoint of VTDR, a fully adjusted model showed that fenofibrate use was associated with an 8% lower risk of progression versus non-use (HR 0.92, 95% CI 0.87-0.98, P=0.01).

Fenofibrate use had a more pronounced impact on the risk of proliferative diabetic retinopathy, with a 24% decrease in progression (PDR; HR 0.76, 95% CI 0.64-0.90) but did not significantly affect the risk of developing diabetic macular edema (DME; HR 0.96, 95% CI 0.90-1.03, P=0.27).

Two clinical trials that evaluated fenofibrate's effect on diabetic eye disease yielded different findings. The FIELD study showed an association between fenofibrate use and fewer laser treatments for DME and PDR but not necessarily overall diabetic retinopathy progression. The ACCORD-Eye trial showed less progression in diabetic retinopathy severity but did not specifically address DME or PDR. Both trials suggested the benefits were limited to patients with mild nonproliferative eye disease.