A study was conducted in Seoul, Republic of Korea to examine the association between the use of fenofibrate and the progression of diabetic retinopathy in type 2 diabetes with metabolic syndrome treated with statins. The information was gathered from a real-world database.

This was a propensity-matched cohort study where the study population receiving statins were matched 1:2 by propensity score into the statin plus fenofibrate group (n=23,692) and statin-only group (n=46,223). A composite of diabetic retinopathy progression including vitreous hemorrhage, vitrectomy, laser photocoagulation, intravitreous injection therapy and retinal detachment was the primary outcome. In the statin only group, the primary outcome was seen as an incidence rate of 14.25 per 1000-person year; the statin plus fenofibrate group had an incidence rate of 12.65 per 1000-person year. This demonstrated that the statin plus fenofibrate group had a significantly lower risk of primary outcome as compared to statin-only group (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.83 to 0.96; p=0.001). Fenofibrate treated group showed marked benefits in patients with retinopathy ((HR, 0.86; 95% CI, 0.78 to 0.94; p=0.001); the group also showed significantly lower risks of vitreous hemorrhage (HR, 0.87; 95% CI, 0.78 to 0.96; p=0.008), laser photocoagulation (HR, 0.89; 95% CI, 0.81 to 0.98, p=0.022) and intravitreous injection therapy (HR, 0.78; 95% CI, 0.66 to 0.92; p=0.003) as compared to statin only group.

From the above findings it can be concluded that, combining fenofibrate with statins therapy significantly lowers the risk of progression of diabetic retinopathy as compared to statins alone in patients with T2D and metabolic syndrome.