Dr Miriam Stoppard on the news that a drug used to control cholesterol could reduce the risk of debilitating diabetic retinopathy by 27%
Diabetes has several debilitating complications, kidney disease and eye disease among them. Is there any way these complications could be prevented?
Well, Oxford University researchers are concentrating on eye disease with the LENS trial and have shown that a drug usually used to lower cholesterol, fenofibrate, reduces the risk of certain complications by 27%.
Diabetes can damage the small blood vessels at the back of the eye, a condition called diabetic retinopathy (DR). DR is in the top five causes of visual loss worldwide and the only major cause to rise in recent decades.
Fenofibrate is a tablet that’s been used to lower cholesterol for more than 30 years.
Previous results had suggested it might be able to slow the progression of diabetic retinopathy, but nothing was conclusive.
The LENS trial compared the effects of fenofibrate with a placebo dummy tablet on the progression of retinopathy in 1,151 adults with type 1 or type 2 diabetes.
The trial ran in Scotland as part of the national diabetic eye screening programme there and all participants had early to moderate diabetic retinopathy when they joined it.
So how did it do?
People who received fenofibrate had a 27% lower risk of needing specialist care or treatment for DR or maculopathy (a progressive eye disease that can lead to vision loss) over four years compared with those who received a placebo.
Treatment with fenofibrate was also linked to a lower risk of developing swelling at the back of the eye (macular oedema) and a lower risk of requiring treatment for retinopathy compared to placebo. The benefits of fenofibrate were similar in people with both type 1 and type 2 diabetes, and in people with both normal and impaired kidney function.
Oxford’s Dr David Preiss, lead author of the study, said: “Diabetic retinopathy remains a leading cause of visual loss. Good control of blood glucose is important but this is very difficult to achieve for many people, and there are few other treatments available. We need simple strategies that can be widely used to reduce the progression of diabetic eye disease.
“Fenofibrate may therefore provide a valuable addition to treat people with early to moderate diabetic retinopathy.”
Dr Lucy Chambers, of Diabetes UK, said: “Eye problems are a frightening and too frequent complication of diabetes. But acting early can stop the first signs of damage progressing into devastating sight loss.
“We’re excited by the positive results from this major trial of a new treatment to slow progression of eye damage, which has the potential to benefit many people with diabetes in the UK.” Very good news.
