Fenofibrate for diabetic retinopathy

Inoue, Kana; Kawano, Sumihiro; Furukawa, Toshi A.; Lois, Noemi; Watanabe, Norio

doi:10.1002/14651858.cd013318

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…While it is generally used for dyslipidemia due to its ability to remarkably reduce TG and increase HDL-C, a different mechanism is involved in its anti-angiogenic effect. Studies suggest that as a peroxisome proliferator-activated receptor-alpha (PPAR-α) agonist, fenofibrate may ameliorate DR through suppression of pro-inflammatory transcription factors NF-κB and activator protein-1, inhibition of vascular endothelial growth factor (VEGF) production, prevention of apoptosis by inhibiting activation of adenosine monophosphate (AMP)-activated protein kinase, and reduction in oxidative stress by upregulating superoxide dismutase [64][65][66][67]. It may also benefit DR through suppressing angiogenesis via inhibiting cytochrome P450 epoxygenase 2C activity [68].…”

Section: Inflammasome-targeting Novel Therapeuticsmentioning

confidence: 99%

Future Therapeutics: Targeting the NLRP3 Inflammasome Pathway to Manage Diabetic Retinopathy Development and Progression

Kuo,

Rupenthal,

Murphy

et al. 2024

IJTM

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While existing local therapies partially restore vision loss from diabetic retinopathy (DR), there is currently no reliable treatment to prevent the onset or stop the progression of the disease. This review seeks to explore the inflammatory molecular mechanisms underpinning DR pathogenesis, which have not been targeted by current interventions. Specifically, this review explores the role of the nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) protein 3 (NLRP3) inflammasome in DR onset and progression. Evidence through clinical trials has begun to note that specific drugs (fenofibrate, metformin) appear effective in slowing DR progression independent of lipid or glucose-lowering, respectively, suggesting that other mechanisms are at play. Novel therapeutics that inhibit the activation of the NLRP3 inflammasome pathway may provide a novel treatment for halting DR progression.

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Section: Inflammasome-targeting Novel Therapeuticsmentioning

confidence: 99%

Future Therapeutics: Targeting the NLRP3 Inflammasome Pathway to Manage Diabetic Retinopathy Development and Progression

Kuo,

Rupenthal,

Murphy

et al. 2024

IJTM

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“…However, it is acknowledged that fenofibrate may benefit the retina independently of its lipidlowering e ects (revised by Stewart and Lois) (Stewart 2018). An ongoing Cochrane Review with a published protocol will evaluate the evidence in this regard (Inoue 2019).…”

Section: Description Of the Prognostic/predictive Model(s)/ Factor(s)mentioning

confidence: 99%

Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy

Perais

Agarwal

Evans

et al. 2023

Cochrane Database of Systematic Reviews

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Background Diabetic retinopathy (DR) is characterised by neurovascular degeneration as a result of chronic hyperglycaemia. Proliferative diabetic retinopathy (PDR) is the most serious complication of DR and can lead to total (central and peripheral) visual loss. PDR is characterised by the presence of abnormal new blood vessels, so‐called “new vessels,” at the optic disc (NVD) or elsewhere in the retina (NVE). PDR can progress to high‐risk characteristics (HRC) PDR (HRC‐PDR), which is defined by the presence of NVD more than one‐fourth to one‐third disc area in size plus vitreous haemorrhage or pre‐retinal haemorrhage, or vitreous haemorrhage or pre‐retinal haemorrhage obscuring more than one disc area. In severe cases, fibrovascular membranes grow over the retinal surface and tractional retinal detachment with sight loss can occur, despite treatment. Although most, if not all, individuals with diabetes will develop DR if they live long enough, only some progress to the sight‐threatening PDR stage. Objectives To determine risk factors for the development of PDR and HRC‐PDR in people with diabetes and DR. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; which contains the Cochrane Eyes and Vision Trials Register; 2022, Issue 5), Ovid MEDLINE, and Ovid Embase. The date of the search was 27 May 2022. Additionally, the search was supplemented by screening reference lists of eligible articles. There were no restrictions to language or year of publication. Selection criteria We included prospective or retrospective cohort studies and case‐control longitudinal studies evaluating prognostic factors for the development and progression of PDR, in people who have not had previous treatment for DR. The target population consisted of adults (≥18 years of age) of any gender, sexual orientation, ethnicity, socioeconomic status, and geographical location, with non‐proliferative diabetic retinopathy (NPDR) or PDR with less than HRC‐PDR, diagnosed as per standard clinical practice. Two review authors independently screened titles and abstracts, and full‐text articles, to determine eligibility; discrepancies were resolved through discussion. We considered prognostic factors measured at baseline and any other time points during the study and in any clinical setting. Outcomes were evaluated at three and eight years (± two years) or lifelong. Data collection and analysis Two review authors independently extracted data from included studies using a data extraction form that we developed and piloted prior to the data collection stage. We resolved any discrepancies through discussion. We used the Quality in Prognosis Studies (QUIPS) tool to assess risk of bias. We conducted meta‐analyses in clinically relevant groups using a random‐effects approach. We reported hazard ratios (HR), odds ratios (OR), and risk ratios (RR) separately for each available ...

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Section: Description Of the Prognostic/predictive Model(s)/ Factor(s)mentioning

confidence: 99%

Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy

Perais

Agarwal

Hogg

et al. 2020

Cochrane Database of Systematic Reviews

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Fenofibrate for diabetic retinopathy

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:To investigate the effects of fenofibrate on the prevention and progression of diabetic retinopathy.

Cited by 5 publications

References 20 publications

Future Therapeutics: Targeting the NLRP3 Inflammasome Pathway to Manage Diabetic Retinopathy Development and Progression

Future Therapeutics: Targeting the NLRP3 Inflammasome Pathway to Manage Diabetic Retinopathy Development and Progression

Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy

Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy

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