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Addition of fenofibrate to statins is associated with risk reduction of diabetic retinopathy progression in patients with type 2 diabetes and metabolic syndrome: A propensity-matched cohort study.

Authors
  • Kim, Nam Hoon1
  • Choi, Jimi1
  • Kim, Young Ho2
  • Lee, Hwa2
  • Kim, Sin Gon3
  • 1 Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. , (North Korea)
  • 2 Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea. , (North Korea)
  • 3 Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. Electronic address: [email protected]. , (North Korea)
Type
Published Article
Journal
Diabetes & metabolism
Publication Date
May 01, 2023
Volume
49
Issue
3
Pages
101428–101428
Identifiers
DOI: 10.1016/j.diabet.2023.101428
PMID: 36720383
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study aimed to determine the association between fenofibrate added to statin therapy and diabetic retinopathy progression. In this propensity-matched study using the Korean National Health Insurance Service cohort (2002-2019), patients with type 2 diabetes and metabolic syndrome (≥ 30 years) receiving statin therapy were matched 1:2 by propensity score into the statin plus fenofibrate group (n = 22,395) and statin-only group (n = 43,191). The primary outcome was a composite of diabetic retinopathy progression including vitreous hemorrhage, vitrectomy, laser photocoagulation, intravitreous injection therapy and retinal detachment. The median (quartiles) follow-up duration was 44.0 (27.6-70.6) months. For the primary outcome, the incidence rate per 1,000 person-years was 9.66 in the statin-only group and 8.68 in the statin-plus-fenofibrate group. The risk of the primary outcome was significantly lower (hazard ratio [HR]=0.88; 95% confidence interval [0.81;0.96] P = 0.005) in the statin-plus-fenofibrate group than in the statin-only group. Only patients with pre-existing retinopathy showed benefits from fenofibrate treatment (HR=0.83 [0.73;0.95] P = 0.006). In addition, the statin plus fenofibrate group exhibited significantly lower risks of vitreous hemorrhage (HR= 0.86 [0.75;0.995] P = 0.042), laser photocoagulation (HR=0.86 [0.77;0.96] P = 0.009) and intravitreous injection therapy (HR=0.73 [0.59;0.90] P = 0.003) than those in the statin-only group. There was no significant interaction between the different characteristics at baseline and the treatment effect. The addition of fenofibrate to statins was associated with significantly lower risk of diabetic retinopathy progression than statin therapy alone in patients with type 2 diabetes and metabolic syndrome. Copyright © 2023 Elsevier Masson SAS. All rights reserved.

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