Fenofibrate: A New Treatment for Diabetic Retinopathy. Molecular Mechanisms and Future Perspectives
Tien Yin Wong.
Despite improving standards of care, people with diabetes remain at risk of development and progression of
diabetic retinopathy (DR) and visual impairment. Identifying novel therapeutic approaches, preferably targeting more than
one pathogenic pathway in DR, and at an earlier stage of disease, is attractive. There is now consistent evidence from two
major trials, the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study and the Action to Control Cardiovascular
Risk in Diabetes Eye (ACCORD-Eye) study, totalling 11,388 people with type 2 diabetes (5,701 treated with
fenofibrate) that fenofibrate reduces the risk of development and progression of DR. Therefore, fenofibrate may be considered
a preventive strategy for patients without DR or early intervention strategy for those with mild DR. A number of
putative therapeutic mechanisms for fenofibrate, both dependent and independent of lipids, have been proposed. A deeper
understanding of the mode of action of fenofibrate will further help to define how best to use fenofibrate clinically as an
adjunct to current management of DR.
Keywords: Diabetic retinopathy, fenofibrate, mode of action, pathogenesis, type 2 diabetes.
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