29 Dec Some Type 2 Diabetics May Benefit From Adding Fenofibrate To Statins
MedicalResearch.com Interview with:
Marshall B. Elam PhD MD
Professor Pharmacology and Medicine
University of Tennessee Health Sciences Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This manuscript presents the findings of extended follow up of patients with Type 2 Diabetes who were treated with fenofibrate, a member of a group of triglyceride lowering medications known as fibrates or PPAR alpha agonists, as part of the Action to Control Cardiovascular Risk in T2DM (ACCORD) study.
ACCORD was designed to test the effect of intensive treatment of cardiovascular risk factors including blood glucose, blood pressure and lipids on risk of heart attack, stroke and cardiac death in patients with Type 2 Diabetes.
The lipid arm of ACCORD tested the hypothesis that adding fenofibrate to statin therapy would further reduce risk of these cardiovascular events.
MedicalResearch.com: What should readers take away from your report?
Response: In ACCORD addition of fenofibrate to statin therapy did not further reduce cardiovascular risk in the overall study cohort, however we observed that a subgroup of study participants with the combination of elevated triglyceride and low “good” cholesterol (HDL) appeared to benefit from fenofibrate therapy.
This manuscript reports the results of extended follow up of the ACCORD participants in the ACCORD Follow On (ACCORDION) study. ACCORDION confirmed the overall neutral effect of fenofibrate observed in the original ACCORD study, however the subgroup with hypertriglyceridemia continued to show reduced cardiovascular risk with fenofibrate treatment during extended follow-up in ACCORDION.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Although the results of these subgroup analyses cannot be considered conclusive, they suggest that patients with Type 2 Diabetes Mellitus who have elevated triglycerides and low HDL-C may benefit from “add-on” fenofibrate therapy. Randomized trials testing the cardiovascular efficacy of fibrates and other triglyceride-lowering treatments in this specific patient population are needed.
MedicalResearch.com: Is there anything else you would like to add?
Response: Both ACCORD and ACCORDION studies were sponsored by the National Heart Lung and Blood Institute of the NIH.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Elam MB, Ginsberg HN, Lovato LC, Corson M, Largay J, Leiter LA, Lopez C, O’Connor PJ, Sweeney ME, Weiss D, Friedewald WT, Buse JB, Gerstein HC, Probstfield J, Grimm R, Ismail-Beigi F, Goff DC, Fleg JL, Rosenberg Y, Byington RP, for the ACCORDION Study Investigators. Association of Fenofibrate Therapy With Long-term Cardiovascular Risk in Statin-Treated Patients With Type 2 Diabetes. JAMA Cardiol.Published online December 28, 2016. doi:10.1001/jamacardio.2016.4828
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Marshall B. Elam PhD MD (2016). Some Type 2 Diabetics May Benefit From Adding Fenofibrate To Statins MedicalResearch.com