title: Antidiabetic action of bezafibrate in a large observational database.
abstract: OBJECTIVE
  The purpose of this study was to test the hypothesis that bezafibrate, an approved fibrate, can prevent or delay type 2 diabetes.
  
  
  METHODS
  This was a retrospective cohort study using data from routine medical practice in the U.K., as captured by the General Practice Research Database (GPRD). Individuals chronically exposed to bezafibrate were compared with individuals chronically exposed to other fibrates. Hazard ratios (HRs) for incident type 2 diabetes were calculated using a Cox proportional hazards model. A post hoc analysis was used to examine the effect of bezafibrate on progression to use of oral antidiabetic medications or insulin in individuals with diabetes at baseline.
  
  
  RESULTS
  Bezafibrate users had a lower hazard for incident diabetes than users of other fibrates (HR 0.66 [95% CI 0.53-0.81]). This effect became stronger with increasing duration of therapy. Post hoc analysis of the effect of bezafibrate on progression of preexisting diabetes also showed a lower hazard for progression to use of antidiabetic medication (0.54 [0.38-0.76]) or progression to use of insulin (0.78 [0.55-1.10]).
  
  
  CONCLUSIONS
  Bezafibrate appears to have clinically important antidiabetic properties. Randomized controlled trials should be considered to assess the utility of bezafibrate in treating patients with diabetes or in preventing diabetes in high-risk patients.
authors.affiliation: 1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. jflory@mail.med.upenn.edu
authors.forename: James H
authors.initials: JH
authors.lastname: Flory
authors.forename: Susan
authors.initials: S
authors.lastname: Ellenberg
authors.forename: Philippe O
authors.initials: PO
authors.lastname: Szapary
authors.forename: Brian L
authors.initials: BL
authors.lastname: Strom
authors.forename: Sean
authors.initials: S
authors.lastname: Hennessy
mesh_terms: D000368:Aged; D001629:Bezafibrate / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D001629:Bezafibrate