Fenofibrate May Reduce Cardiovascular Disease Risk in Statin-Treated Type 2 Diabetes Patients

A new study found that the combination of statin treatment and fenofibrate may reduce the risk of cardiovascular disease in patients with type 2 diabetes who have hypertriglyceridemia and low high-density lipoprotein cholesterol.

Researchers performed an extended posttrial follow-up on participants in the Action to Control Cardiovascular Risk in Diabetes Lipid Study from July 2009 to October 2014. They selected 4644 participants from the original study who had type 2 diabetes, and cardiovascular disease or cardiovascular disease risks factors, and high-density lipoprotein levels below 50 mg/dL. The sample included 1445 women, 1094 nonwhite participants, and 1620 participants with preexisting cardiovascular events.
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According to the results, values of triglyceride and high-density lipoprotein were equal between participants who received fenofibrate in the study or a placebo. In a postrandomized follow-up, the hazard ratio (.93) for participants who received the fenofibrate or placebo was similar to the hazard ratio (.92) in the Action to Control Cardiovascular Risk in Diabetes Lipid Study. In addition, they found that only 4.3% of participants continued to receive fenofibrate treatment after completing the Action Control Cardiovascular Risk in Diabetes Lipid Study.

While results comparing the triglyceride and high-density lipoprotein values and hazard ratios between the original and follow-up study were neutral, researchers did find evidence that fenofibrate reduced cardiovascular disease in participants with dyslipidemia, who had triglyceride levels greater than 204 mg/dL and high-density lipoprotein cholesterol levels below 34 mg/dL.

“The continued observation of heterogeneity of treatment response by baseline lipids suggests that fenofibrate therapy may reduce CVD in patients with diabetes with hypertriglyceridemia and low high-density lipoprotein cholesterol,” the researchers concluded.

—Melissa Weiss

Reference:

Elam MB, Ginsberg HN, Lovato LC, et al. Association of fenofibrate therapy with long-term cardiovascular risk in statin-treated patients with type 2 diabetes [published online December 28, 2016]. JAMA Cardiology. doi:10.1001/jamacardio.2016.4828.