by Michael Woodhead
In what Australian endocrinologists describe as a major breakthrough, the lipid-lowering drug fenofibrate has been shown to reduce the risk of amputation in diabetic patients by almost half.
Results from the NHMRC-funded FIELD study involving almost 10,000 patients with type 2 diabetes have shown that over a five year period those who took fenofibrate 200mg daily had a 36% lower rate of amputations overall (70 versus 45 events) compared to patients randomized to placebo.
The fibrate drug was even more effective in preventing minor amputation (below the ankle) in diabetic patients without known large vessel disease, in whom the rate was 47% lower than the placebo group.
The NHMRC Clinical Trails Centre researchers, presenting their findings at the Heart Foundation Conference in Brisbane this week, said the benefits were seen regardless of the degree of glycaemic control or dyslipidaemia or use of ACE inhibitors or antagonist drugs. This suggests the fenofibrate benefits on amputation are though non-lipid mechanisms, they say.
“These findings represent a significant breakthrough and are likely to change treatment for the prevention of diabetes-related lower limb amputation in high risk individuals,” they conclude.
The high risk patients were those with classical markers of macrovasular and microvascular complications such as smoking, high BP, skin ulcers and long duration of diabetes, they add.
14 May 2009