According to researchers from the University of Pennsylvania’s Scheie Eye Institute, the cholesterol-lowering drug fenofibrate may be helpful in reducing a patient’s risk of progressing to proliferative diabetic retinopathy (DR); however, another class of  cholesterol medication, statins, may actually increase the risk of progression. The study found that neither had a protective effect for diabetic macular edema (DME). The team presented their findings at ARVO 2019 in Vancouver last week.¹

The retrospective cohort study assessed the effect of fenofibrate and statin use on the progression from nonproliferative DR to vision-threatening DR, proliferative DR or DME. In the 5,047 nonproliferative DR patients who received a prescription for fenofibrate, 899, 127 and 754 progressed to vision-threatening DR, proliferative DR and DME, respectively. Among the 45,769 nonproliferative DR patients who received a statin prescription, 8,209, 1,387 and 6,652 progressed, respectively.¹

Analysis shows taking fenofibrate was associated with a protective effect for both vision-threatening and proliferative DR, but not DME. While statin use was not associated with progression to vision-threatening DR or DME, it was associated with an increased hazard for proliferative DR.¹

The findings contradict an earlier report published in JAMA Ophthalmology, which suggests statin therapy lowers a patient’s risk of both nonproliferative and proliferative DR, at least in a Taiwanese cohort.² 

1. VanderBeek BL, Bavinger JC, Yu Y. Fenofibrate and statin use and the risk of progression to vision threatening diabetic retinopathy. ARVO 2019. 2. Kang EY, Chen TH, Garg SJ, et al. Association of statin therapy with prevention of vision-threatening diabetic retinopathy. JAMA Ophthalmol. January 10, 2019. [Epub ahead of print]..