Fenofibrate reduces laser photocoagulation (FIELD)
Clinical Question
Does fenofibrate reduce the need for laser photocoagulation in patients with type 2 diabetes?
Bottom Line
In patients with type 2 diabetes mellitus fenofibrate (Antara, Lofibra, Tricor) modestly reduces the number of laser treatments for retinopathy. (LOE = 1b)
Reference
Keech AC, Mitchell P, Summanen PA, et al, for the FIELD study investigators. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet 2007;370(9600):1687-1697. [PMID:17988728]
Study Design
Randomized controlled trial (double-blinded)
Funding
Industry + govt
Allocation
Concealed
Setting
Outpatient (any)
Synopsis
The focus of this report is on the effect of fenofibrate on laser photocoagulation. The patients, between the ages of 50 years and 75 years with type 2 diabetes mellitus, were randomly assigned to receive 200 mg micronized fenofibrate every day or a matching placebo. The patients all had a total cholesterol level between 3.0 mmol/L and 6.5 mmol/L (115 and 250 mg/dL), plus either a total cholesterol/high density lipoprotein ratio of 4.0 or higher, or a triglyceride level between 1.0 mmol/L and 5.0 mmol/L (88 and 440 mg/dL). The use of laser treatment was adjudicated by at least 2 ophthalmologists masked to treatment allocation and were analyzed by intention to treat. At baseline, the 2 groups were similar in self-reported history of retinopathy. After approximately 5 years of follow up, 3.4% of patients receiving fenofibrate experienced their first laser treatment compared with 4.9% of the patients taking placebo (number needed to treat [NNT] for 5 years = 67; 95% CI, 44 - 139). Among patients with retinopathy at baseline, the NNT is 17.
Citation
Barry, Henry, et al., editors. "Fenofibrate Reduces Laser Photocoagulation (FIELD)." EE+ POEM Archive, John Wiley & Sons, 2024. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426432/all/Fenofibrate_reduces_laser_photocoagulation__FIELD_.
Fenofibrate reduces laser photocoagulation (FIELD). In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2024. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426432/all/Fenofibrate_reduces_laser_photocoagulation__FIELD_. Accessed November 25, 2024.
Fenofibrate reduces laser photocoagulation (FIELD). (2024). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426432/all/Fenofibrate_reduces_laser_photocoagulation__FIELD_
Fenofibrate Reduces Laser Photocoagulation (FIELD) [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2024. [cited 2024 November 25]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426432/all/Fenofibrate_reduces_laser_photocoagulation__FIELD_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Fenofibrate reduces laser photocoagulation (FIELD)
ID - 426432
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426432/all/Fenofibrate_reduces_laser_photocoagulation__FIELD_
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
ER -