2017 Issues   /   February 2017

Fenofibrate Associated With Reduced CV Disease in Diabetics

USM By U.S. Medicine
February 14, 2017

MEMPHIS—Cardiovascular risk is increased in patients with Type 2 diabetes, at least partly because of hypertriglyceridemia and low high-density lipoprotein cholesterol.

A study published online by JAMA Cardiology sought to determine if the risk is reduced by adding fenofibrate, which lowers triglycerides, to statin therapy.1

Researchers from the Memphis VAMC and the University of Tennessee Health Sciences Center, also in Memphis, and colleagues used a post-trial follow-up of the Action to Control Cardiovascular Risk in Diabetes Lipid Study to help answer the question. Results indicate that fenofibrate therapy was associated with reduced cardiovascular disease in study participants with dyslipidemia, defined as triglyceride levels greater than 204 mg/dL and high-density lipoprotein cholesterol levels less than 34 mg/dL.

The extended post-trial follow-up of the ACCORD Lipid Study participants was conducted between July 2009 and October 2014 and involved 4,644 participants who were selected based on the presence of Type 2 diabetes and either prevalent CVD or CVD risk factors and high-density lipoprotein levels less than 50 mg/dL (<55 mg/dL for women and African-American individuals).

In the passive follow-up of study participants previously treated with fenofibrate or masked placebo, researchers were looking for occurrence of cardiovascular outcomes, including primary composite outcome of fatal and nonfatal myocardial infarction and stroke in all participants and in pre-specified subgroups.

Researchers note that only 4.3% of study participants continued treatment with fenofibrate following completion of ACCORD and that high-density lipoprotein and triglyceride values rapidly equalized among participants originally randomized to fenofibrate or placebo.

Over a median total post-randomization follow-up of 9.7 years, the hazard ratio (HR) for the primary study outcome among participants originally randomized to fenofibrate vs placebo, 0.93, was comparable with that originally observed in ACCORD, 0.92.

“Despite these overall neutral results, we continued to find evidence that fenofibrate therapy effectively reduced CVD in study participants with dyslipidemia, defined as triglyceride levels greater than 204 mg/dL and high-density lipoprotein cholesterol levels less than 34 mg/dL (HR, 0.73; 95% CI, 0.56-0.95),” according to study authors.

  1. Elam MB, Ginsberg HN, Lovato LC, Corson M, et. al. ACCORDION Study Investigators. Association of Fenofibrate Therapy With Long-term Cardiovascular Risk in Statin-Treated Patients With Type 2 Diabetes. JAMA Cardiol. 2016 Dec 28. doi: 10.1001/jamacardio.2016.4828. [Epub ahead of print] PubMed PMID: 28030716.

Related Articles

How Veterans Feel About Remote Management of Their Care

While implantable devices have shown promise in reducing rehospitalization for heart failure (HF), VA researchers sought to determine if options that are less expensive and non-invasive would have comparable results.

Legislation: Clinicians Must Be Involved in Formulary Design, Purchasing

Legislation to prevent VA from outsourcing creation of its drug formulary and to require more input from medical professions is being considered in Congress.


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

How Veterans Feel About Remote Management of Their Care

While implantable devices have shown promise in reducing rehospitalization for heart failure (HF), VA researchers sought to determine if options that are less expensive and non-invasive would have comparable results.

Department of Veterans Affairs (VA)

Legislation: Clinicians Must Be Involved in Formulary Design, Purchasing

Legislation to prevent VA from outsourcing creation of its drug formulary and to require more input from medical professions is being considered in Congress.

Department of Veterans Affairs (VA)

GAO: VA Needs Better Planning for ‘Complex’ Appeals System Overhaul

VA’s Consolidated Mail Outpatient Pharmacy (CMOP) in Charleston, SC. New legislation is seeking to increase clinician input into formulary decisionmaking. WASHINGTON — Legislation to prevent VA from outsourcing creation of its drug formulary and to... View Article

Department of Veterans Affairs (VA)

Community Providers Unprepared to Serve Veterans Under Choice Program

As the debate about increasing access for veterans to community-based provider heats up, a serious problem has emerged: Few providers outside the VA health system appear to be prepared to meet the unique challenges of the veteran population.

Department of Veterans Affairs (VA)

Former VA Secretary Nominee Claims Allegations Against Him Are False

Veterans’ groups expressed concern last month regarding a “lack of permanent leadership at the department,” after Rear Adm. Ronny L. Jackson, MD, withdrew his name from consideration as VA secretary amid anonymous allegations of misconduct.

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up