The online publication HealthDay News, for November 14, 2005, reported the surprising news that the cholesterol-lowering drug TriCor (fenofibrate, from Abbott) reduced incidence of heart attacks and coronary interventions in individuals with type 2 diabetes, while at the same time achieving “pronounced reductions in microvascular complications such as diabetic eye disease and amputations.”
Lead researcher Dr. Anthony Keech, from Sidney, Australia, reporting to the American Heart Association about his extensive testing of TriCor, related that there are nearly 300 million people with diabetes in the world, and perhaps 30 million of them will have a vascular event in the next two years. “This drug could help avoid something like two million vascular events a year,” he stated.
There were some measurable reductions in cardiac events; but, even more pronounced were the observed microvascular benefits of TriCor. Diabetes can cause a deterioration in the small blood vessels, which can lead to kidney failure, poor limb healing, and eye damage. In Dr. Keech’s trial (the FIELD Study: Fenofibrate Intervention and Event Lowering in Diabetes), involving 9,975 patients with type 2 diabetes, from Finland, Australia, and New Zealand, studied over a five-year period, those taking fenofibrate had a 30 percent reduction in the need for laser treatment for diabetic eye disease.
There was also (Dr. Keech reported) a reduction in the progression of urinary albumin (a marker of kidney disease), a 30 percent reduction in need for amputation, and an 18 percent drop in instances of angina pectoris (chest pain; usually associated with heart problems). The FIELD study findings are the first to suggest such a medication could reduce diabetic eye and kidney problems.
All the connections are not fully understood, but the data are in, and they
look good for diabetics. Fenofibrate will not replace the statins, but should
find a place in combination therapy. Now that its benefits for treating diabetic
eye and kidney disease have been spotlighted, it is time for tests directly
targeting these issues—and then new prescribing guidelines can be written.
The above are promising results; they need to be tested and replicated before
this medication is widely prescribed for this purpose. We hope this takes place
promptly.