Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Predicting Fenofibrate’s Effect on CV Risk in T2D
Diabetes Care; ePub 2018 Feb 22; Koopal, et al
Treatment effect of fenofibrate in patients with type 2 diabetes varies widely, according to a study involving >17,000 individuals. Furthermore, the effect is larger in those with dyslipidemia. Participants were from the ACCORD and SMART observational trials. Using the FIELD model, investigators estimated the effect of fenofibrate treatment on cardiovascular (CV) risk reduction. Among the results:
- External validation of the FIELD risk model showed good calibration and moderate discrimination in both cohorts.
- Median 5-year risk of major CV events in patients with and without dyslipidemia were 9% and 7%, respectively.
- The median absolute risk reduction was 2% in patients with dyslipidemia, corresponding with a number needed to treat of 47.
- It was <1% in patients without dyslipidemia (number needed to treat 455).
The authors noted that their method of predicting individualized treatment effect of fenofibrate on CV risk reduction can be used to guide clinical decision-making.
Koopal C, Visseren F, Westerink J, van der Graaf Y, Ginsberg H, Keech A. Predicting the effect of fenofibrate on cardiovascular risk for individual patients with type 2 diabetes mellitus. [Published online ahead of print February 22, 2018]. Diabetes Care. doi:10.2337/dc17-0968.