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Fenofibrate Might Reduce Amputations Caused by Microvascular Disease in Patients with Diabetes

• The Field study - full disclosure
• Fenofibrate
• FENOFIBRATE FOR DIABETIC FOOT ULCER AND ALBUMINURIA

The Field study - full disclosure

Sheldon S Ball, Veterans Administration, 12 Jun 2009 11:12 AM EST

Competing interests: None declared

Whe I go back to the original publication, it seems this editorial selectively paints a rosy picture. Other findings not included here 1) fenofibrate group had significant increases in pancreatitis & pulmonary embolism 2) all-cause mortality was higher in the fibrate group than the placebo group (7.3% vs 6.6%) (not significant, but worrisome) 3) more frequent initiation of statin therapy in patients allocated placebo may confound interpretation

Keech A, Simes RJ, Barter P, Best J, Scott R, Taskinen MR, Forder P, Pillai A, Davis T, Glasziou P, Drury P, Kesaniemi YA, Sullivan D, Hunt D, Colman P, d'Emden M, Whiting M, Ehnholm C, Laakso M; FIELD study investigators. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005 Nov 26;366(9500):1849-61. PMID: 16310551

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Fenofibrate

Bernard A. Yablin(MD), URMC(retired), 17 Jun 2009 3:02 PM EST

Competing interests: None declared

How often should patients be tested for pvd? Should fenofibrate be used in all patients with Type 2 diabetes

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FENOFIBRATE FOR DIABETIC FOOT ULCER AND ALBUMINURIA

Bimal K Agrawal, Deptt of Medicine,M M Medical College, M M University, Mullana, India, 7 Aug 2009 12:26 PM EST

Competing interests: None declared

The study shows the drug is particularly effective in preventing amputation in subgroup of patients who have diabetic foot ulcer or albuminuria (marker for microvascular disease). NNT in those cases is 25. I believe fenofibrate should be initiated in such cases.Life can be so disabling after amputation that we should try and avoid such situation wherever we can.

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