No Cardiovascular Benefit With Fenofibrate in T2D and Hypertriglyceridemia

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There was no significant difference in the composite outcome in patients on fenofibrate, statin, or fenofibrate-statin combination therapy.
There was no significant difference in the composite outcome in patients on fenofibrate, statin, or fenofibrate-statin combination therapy.

There is no cardiovascular benefit to adding fenofibrate to therapy in patients with type 2 diabetes (T2D) and hypertriglyceridemia, according to an abstract presented at ENDO 2018: The Endocrine Society Annual Meeting, held March 17-20 in Chicago, Illinois.

The use of fenofibrate for treating cardiovascular disease (CVD) remains controversial; therefore researchers conducted a retrospective cohort study on the effect of fenofibrate on the risk of myocardial infarction, stroke, or all-cause mortality using electronic health records of 7058 adult patients with T2D and hypertriglyceridemia (>200 mg/dL) who were treated with fenofibrate or statin or a fenofibrate-statin combination.

Using a regression model, they found no significant difference in the composite outcome of myocardial infarction, stroke, or all-cause mortality in patients on fenofibrate or statin or fenofibrate-statin combination therapy. They did observe a reduction in all-cause mortality with statin therapy (P =.019), although this trend did not appear to be significant with fenofibrate or fenofibrate-statin combination therapy.

Fenofibrate-statin combination therapy improves lipid profiles in patients with dyslipidemia and T2D but this has not been demonstrated as a CVD benefit. In a sub-group analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and in post-ACCORD studies, a reduction in CVD with fenofibrate therapy has been demonstrated in patients with triglycerides >204 mg/dL and HDL cholesterol levels <34 mg/dL at 5-year follow-up (P =.06) and 9.7 years (P =.05), respectively.

“Our study, like ACCORD, demonstrated a mortality benefit with statin treatment but did not find a significant additional benefit of fenofibrate-statin combination therapy in reducing CVD risk in T2D patients” concluded the researchers.

Visit Endocrinology Advisor's conference section for more highlights from ENDO 2018.

Reference

Azim S, Ji X, Kattan M, et al. Fenofibrate therapy in patients with type 2 diabetes with hypertriglyceridemia and risk of myocardial infarction, stroke or all-cause mortality. Presented at: ENDO 2018: The Endocrine Society Annual Meeting; Chicago, Illiois; March 17-20, 2018. Abstract SUN-002.

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