Cholesterol-lowering drug slows progression of eye disease in people with diabetes
Key Takeaways
- A clinical trial has demonstrated that an old cholesterol drug reduces the risk of progression of diabetic retinopathy.
- The drug may provide a much-needed treatment alternative for people with early to moderate diabetic retinopathy.
Diabetes can cause damage to the small blood vessels at the back of the eye, a condition called diabetic retinopathy. Current treatments, including laser surgery and eye injections, have major downsides, so there is a need for early interventions that could reduce the number of people that progress to needing treatment.
Fenofibrate is a tablet that has been used to lower cholesterol for more than 30 years. Previous results from sub-studies of trials looking into treatments for heart disease had suggested that fenofibrate might be able to slow the progression of diabetic retinopathy but more conclusive results were needed.
Coordinated by Oxford Population Health, the LENS (Lowering Events in Non-proliferative retinopathy in Scotland) trial compared the effects of fenofibrate with a placebo (dummy tablet) on the progression of retinopathy in 1,151 adults with type 1 or type 2 diabetes in Scotland as part of the national routine diabetic eye screening program. All of the participants had early to moderate diabetic retinopathy when they joined the trial.
The results showed that people who received fenofibrate had a 27% lower risk of needing to be referred for specialist care or treatment for diabetic retinopathy or maculopathy (a progressive eye disease that can lead to vision loss) over four years compared with people who were assigned to receive a placebo. Treatment with fenofibrate was also associated with a lower risk of developing macular edema (swelling at the back of the eye) and a lower risk of requiring treatment for retinopathy compared to placebo. The benefits of fenofibrate were similar in people with both type 1 and type 2 diabetes, and in people with both normal and impaired kidney function. The results were presented by lead author David Preiss, PhD, at the American Diabetes Association Scientific Sessions and published inNEJM Evidence.
Preiss said, “We need simple strategies that can be widely used to reduce the progression of diabetic eye disease. Fenofibrate may therefore provide a valuable addition to treat people with early to moderate diabetic retinopathy.” Asked to comment, session moderator Thomas W. Gardner, MD, told Medscape Medical News, “I think this is very encouraging…It suggests that the progression of retinopathy can be lowered by not 100%, but by a third, maybe, which is substantial. Every little bit helps. And it can be done with a very safe drug, a very inexpensive drug that’s taken by mouth.”
Edited by Miriam Kaplan, PhD
Sources:
University of Oxford, Medical Xpress, June 24, 2024; see source articleMiriam Tucker, Medscape Medical News, June 23, 2024; see source article