New data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study has shown that taking the drug fenofibrate (brand names TriCor, Lofibra, and others) may help people with Type 2 diabetes and symptoms of the metabolic syndrome reduce their risk of cardiovascular disease.
I wrote about a substudy of the FIELD study last year in the blog entry “Fibrate Drug Alone Doesn’t Cut Heart Risks for Type 2’s.” The data released at that time showed that five years of fenofibrate therapy alone did not decrease markers of cardiovascular disease in people with Type 2 diabetes any more than taking a placebo (inactive pill) did.
However, a new analysis, published in the March 2009 issues of Diabetes Care, looked at people with Type 2 diabetes and a cluster of factors that can raise people’s risk of heart disease (and diabetes for those who don’t already have it), such as abdominal obesity, high blood pressure, high fasting blood glucose, high triglycerides, and low HDL (or “good”) cholesterol. Typically, when a person has three or more of these conditions, he is considered to have metabolic syndrome).
The FIELD researchers examined their data to find out whether people who had symptoms of the metabolic syndrome would benefit more from taking fenofibrate than those who didn’t have the condition. They found that more than 80% of the study’s nearly 10,000 participants did have metabolic syndrome, and that those with metabolic syndrome had a higher risk of cardiovascular “events” (such as heart attack) than those without.
The researchers also found that certain groups of people who took fenofibrate over the five-year study period had significantly lower rates of cardiovascular events. Namely, people with high blood pressure and those with abnormal blood lipid (triglyceride and cholesterol) levels saw the greatest risk reduction from treatment with fenofibrate. The researchers also found that people who had no history of cardiovascular disease lowered their risk more than those who had already experienced a cardiovascular event.
You can read the study abstract here.
Another study of fenofibrate, which I also blogged about last year (in “Two Lipid Drugs May Be Better Than One”) found that combining fenofibrate with the statin drug simvastatin (Zocor) led to fewer markers for cardiovascular disease risk in people with Type 2 diabetes after 12 weeks.
The FIELD researchers concluded that treatment with fenofibrate is likely to be more useful in people with Type 2 diabetes who also have features of metabolic syndrome.