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
Main finding · Composite DR progressionResult — go to the resultHazard ratio 0.88 95% CI 0.81–0.96Authors' conclusion
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.
Study context
- Population
- Patients aged ≥30 years with T2D and metabolic syndrome receiving statin therapy, Korean National Health Insurance Service cohort (2002–2019)matched cohort
- Participants
- 22,395 vs 43,191
- Exposure
- Statin plus fenofibrate vs statin only
- Statin plus fenofibraten = 22,395
- Statin-onlyn = 43,191reference
- Outcome
- Composite of DR progression:
- Vitreous hemorrhage
- Vitrectomy
- Laser photocoagulation
- Intravitreous injection therapy
- Retinal detachment
- Follow-up
- Median 44.0 (27.6-70.6) months
Methodological detailspropensity-score matched 1:2, Korean National Health Insurance Service cohort (2002-2019)
- Propensity-score matched 1:2
- Korean National Health Insurance Service cohort (2002-2019)
Main finding
Composite DR progression
Hazard ratio
0.88
95% CI 0.81–0.96
P = 0.005
By group
Statin plus fenofibratevs Statin-only
HR 0.88 (95% CI 0.81–0.96); P = 0.005
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Primary outcome in patients with pre-existing retinopathy | 0.83 (0.73–0.95) | P = 0.006 | |
| Vitreous hemorrhage | 0.86 (0.75–0.995) | P = 0.042 | |
| Laser photocoagulation | 0.86 (0.77–0.96) | P = 0.009 | |
| Intravitreous injection therapy | 0.73 (0.59–0.90) | P = 0.003 | |
| 0.512Hazard ratio (log scale) |
Primary outcome in patients with pre-existing retinopathy
- Only patients with pre-existing retinopathy showed benefit from fenofibrate
Interaction of baseline characteristics with treatment effect
- No significant interaction between baseline characteristics and treatment effect
Original publication
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. Diabetes Metab. Published 28 January 2023. doi:10.
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