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.
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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.