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Diabetes Patients with High Triglycerides and Low HDL Cholesterol Get the Most Benefit From Fenofibrate Treatment: New Data From the FIELD Study
Date:2/26/2009

y 11%, P=0.035). This was mainly driven by 24% reduction in nonfatal MI (P=0.01) and 21% reduction in coronary revascularisation (P=0.003).(5)

There was also evidence of benefit with fenofibrate for microvascular endpoints, in particular reduction in first laser treatment for retinopathy (by 31%, P=0.0002).(6, 7)

What is the metabolic syndrome?

The metabolic syndrome is characterised by a clustering of cardiovascular risk factors which increase the risk of type 2 diabetes and cardiovascular disease. Although the definition of metabolic syndrome varies among different guidelines, one of the most widely accepted is that of the NCEP ATPIII(4) which defines metabolic syndrome by the following criteria:

    -- Abdominal obesity (waist circumference >40 inches in men and
       >35 inches in women) AND
    -- Triglycerides greater than or equal to 150 mg/dL
    -- HDL cholesterol <40 mg/dL in men and <50 mg/dL in women
    -- Blood pressure greater than or equal to 130/85 mmHg (or on
       antihypertensive treatment)
    -- Elevated fasting plasma glucose (greater than or equal to 100 mg/dL).

What is meant by number needed to treat?

The NNT value provides a clinical context to the absolute reduction in risk. This value is defined by the inverse of the absolute reduction in risk. In this analysis, the NNT for fenofibrate in patients with marked atherogenic dyslipidaemia was 23 patients needing to be treated for one event to be prevented.

By comparison, the Cholesterol Treatment Trialists' (CTT) Collaborators (8) reported an absolute reduction in 5-year risk of major vascular events in diabetes patients treated with statin therapy of 3.6%, i.e. NNT = 28.

References

1. Russell Scott, Richard O'Brien, Greg Fulcher, Chris Pardy, Michael d'Emden, Dana Tse, Maria-Riitta Taskinen, Christian Ehnholm, Anthony Keech
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