Cholesterol Drug Slows Vision Loss in Diabetic Patients

A groundbreaking study has demonstrated that fenofibrate, a drug primarily utilized for managing blood fat levels, can significantly slow the progression of diabetic retinopathy, a common diabetes-related eye condition. Revealed at the American Diabetes Association's (ADA) 84th Scientific Sessions in Orlando and published in NEJM Evidence, the Lowering Events in Non-proliferative retinopathy in Scotland (LENS) Trial is the first large-scale research to explore fenofibrate's impact on early-stage diabetic retinopathy.

Diabetic retinopathy, a leading cause of vision loss worldwide, has seen a rise in prevalence over the past three decades. It occurs when high blood sugar levels damage the retina's blood vessels, potentially resulting in vision impairment or blindness. Although controlling blood glucose is crucial to slow disease progression, achieving this is often challenging for many patients, and existing treatment options are limited for those in the early stages of the condition. The LENS Trial aimed to evaluate fenofibrate, a medication traditionally used for high cholesterol, to see if it could be repurposed to address this gap.

The study was conducted within Scotland's Diabetic Eye Screening (DES) program, a national initiative that offers regular retinal imaging for all diabetic patients aged 12 and above. A total of 1,151 adults with early diabetic retinopathy or maculopathy participated in this randomized controlled trial. They were assigned to receive either 145 mg of fenofibrate or a placebo. The primary outcome measured was the development of referable diabetic retinopathy or maculopathy, conditions that necessitate specialist ophthalmic review or treatment like laser therapy, intravitreal injections, or vitrectomy.

Over four years, the trial results showed that those taking fenofibrate experienced a 27% reduction in disease progression compared to the placebo group (22.7% vs. 29.2%). This finding was statistically significant, indicating a strong potential for fenofibrate as a treatment option for early-stage diabetic retinopathy. Additionally, fenofibrate significantly lowered the risk of overall retinopathy progression and the development of macular edema, a condition characterized by retinal swelling.

Dr. David Preiss, an Associate Professor at Oxford Population Health, emphasized the need for straightforward and widely accessible strategies to combat diabetic retinopathy. He highlighted that the LENS trial's findings suggest fenofibrate could be a valuable addition to the treatment options available for this condition.

The trial's collaboration with the Scottish DES program has enabled the collection of 9,000 retinal images, which will be further analyzed using machine learning tools to better understand fenofibrate's effects on diabetic eyes. Participants will continue to be monitored through national health records to assess the long-term benefits of fenofibrate therapy.

The ADA's 84th Scientific Sessions, held from June 21-24 in Orlando, is the world's largest event dedicated to diabetes research, prevention, and care. It gathers over 11,000 healthcare professionals from around the globe to share groundbreaking research and discuss advances in diabetes treatment. This esteemed event provides attendees with exclusive access to numerous research presentations and opportunities to engage with leading diabetes experts.

The American Diabetes Association (ADA) has been at the forefront of diabetes research, advocacy, and education for 83 years. The organization works tirelessly to enhance the quality of life for millions of Americans living with diabetes or prediabetes and aims to drive progress towards finding a cure. The ADA's efforts include advocacy, program development, and public education initiatives aimed at bending the curve on the diabetes epidemic and supporting those affected by the disease.