More clinical lessons from the FIELD study.

Abstract

INTRODUCTION:

The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study investigated the effect of fenofibrate treatment in 9,795 patients with type 2 diabetes.

RESULTS AND DISCUSSION:

Reduction in major coronary events (the primary endpoint) and total cardiovascular disease (CVD) events (the secondary endpoint) was similar (relative risk reduction 11%), but only significant for total CVD events (p = 0.035). The benefit of fenofibrate treatment was greater in patients with mixed dyslipidaemia, especially in those with triglycerides >2.3 mmol/L and low plasma levels of high-density lipoprotein cholesterol (relative risk reduction 27%, p = 0.005). There were also microvascular benefits associated with fenofibrate treatment, specifically reduction in the rate of laser therapy for retinopathy (by 30%, p < 0.001), non-traumatic amputation (by 38%, p = 0.011) and progression of albuminuria (p < 0.002). Fenofibrate was generally well tolerated alone or in combination with a statin.

CONCLUSIONS:

Overall, the FIELD study data support the use of fenofibrate for CVD prevention in diabetes, ideally in patients without prior macrovascular or microvascular complications. Fenofibrate may also have a role as a preventive treatment for diabetic retinopathy. Addition of fenofibrate to statin therapy may a logical progression from the FIELD study data, although the efficacy and tolerability of this approach needs to be evaluated in prospective outcome studies.

• Authors: Sergio Fazio
• Journal: Cardiovascular drugs and therapy (Cardiovasc Drugs Ther) Vol. 23 Issue 3 Pg. 235-41 (Jun 2009) ISSN: 1573-7241 [Electronic] United States
• PMID: 19160032 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Hypolipidemic Agents
• Cholesterol
• Fenofibrate

Topics

• Cardiovascular Diseases (etiology, prevention & control)
• Cholesterol (blood)
• Diabetes Mellitus, Type 2 (blood, complications)
• Dyslipidemias (complications, drug therapy)
• Fenofibrate (adverse effects, therapeutic use)
• Humans
• Hypolipidemic Agents (adverse effects, therapeutic use)