Fenofibrate was associated with a reduced risk of progression to vision-threatening forms of diabetic retinopathy in a new large database study.
"The possibility that an oral medication originally used for a different disease may be beneficial for the management of diabetic eye disease is exciting," writes Robert N. Frank, MD, emeritus professor of ophthalmology at Wayne State University in Detroit, Michigan, in an accompanying editorial to the study published in JAMA Ophthalmology.
The oral drug typically prescribed to lower lipids is also being studied in a number of ongoing clinical trials for the prevention of worsening of diabetic retinopathy, and was approved for that indication in Australia back in 2013.
Two small trials, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye study and Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, have already shown a reduction in vision-threatening diabetic retinopathy with fenofibrate.
But the results of these previous studies were somewhat mixed in terms of overall progression of diabetic retinopathy, and guidelines for the drug's use for this indication have not been consistent across professional societies. The American Academy of Ophthalmology preferred practice pattern for diabetic retinopathy does not comment on fenofibrate use, whereas the American Diabetes Association position statement argues for a collaborative approach to fenofibrate use.
