title: Fenofibrate: a new treatment for diabetic retinopathy. Molecular mechanisms and future perspectives.
abstract: Despite improving standards of care, people with diabetes remain at risk of development and progression of diabetic retinopathy (DR) and visual impairment. Identifying novel therapeutic approaches, preferably targeting more than one pathogenic pathway in DR, and at an earlier stage of disease, is attractive. There is now consistent evidence from two major trials, the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study and the Action to Control Cardiovascular Risk in Diabetes Eye (ACCORD-Eye) study, totalling 11,388 people with type 2 diabetes (5,701 treated with fenofibrate) that fenofibrate reduces the risk of development and progression of DR. Therefore, fenofibrate may be considered a preventive strategy for patients without DR or early intervention strategy for those with mild DR. A number of putative therapeutic mechanisms for fenofibrate, both dependent and independent of lipids, have been proposed. A deeper understanding of the mode of action of fenofibrate will further help to define how best to use fenofibrate clinically as an adjunct to current management of DR.
authors.affiliation: Diabetes and Metabolism Research Unit, Institut de Recerca Hospital Universitari Vall d’Hebron and CIBERDEM, Barcelona, Spain. rafael.simo@vhir.org
authors.forename: Rafael
authors.initials: R
authors.lastname: Simó
authors.forename: Sayon
authors.initials: S
authors.lastname: Roy
authors.forename: Francine
authors.initials: F
authors.lastname: Behar-Cohen
authors.forename: Anthony
authors.initials: A
authors.lastname: Keech
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D018450:Disease Progression; D011345:Fenofibrate / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology* / Q000627:therapeutic use*
chemical_list: D000960:Hypolipidemic Agents; D011345:Fenofibrate