Fenofibrate Reduces Need for Laser Treatment for Diabetic Retinopathy

Patients with diabetes who take fenofibrate are less likely to need laser treatment for retinopathy, but the drug's mechanism of action remains unclear, reports a Lancet study published online.
Nearly 10,000 adults with type 2 diabetes who did not require lipid-lowering therapy were randomized to receive daily fenofibrate or placebo. During a mean follow-up of about 5 years, significantly fewer fenofibrate recipients than placebo recipients underwent laser treatment for retinopathy (3.4% vs. 4.9%). Between-groups differences were seen within 8 months of treatment initiation.
In a substudy of patients who underwent serial retinal photography, fenofibrate appeared to protect against retinopathy progression only among those with the condition at baseline.
The authors found no association between plasma lipid levels and retinopathy. Rather, they speculate that fenofibrate "might have anti-apoptotic, anti-inflammatory, and anti-oxidative effects and might also improve vascular reactivity, thus attenuating progression of diabetic retinopathy and the need for laser treatment."