Fenofibrate for preventing progression of diabetic retinopathy: a systematic review

uma revisão sistemática

Abstract

Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus (DM) associated with marked apoptosis of retinal capillary cells, which can progress to partial to total vision loss, negatively impacting the quality of life of a person living with diabetes. More advanced stages of the disease often require high-cost interventions, such as retinal laser and intravitreal injections, which do not always guarantee satisfactory results. In this context, the present study aims to systematically review the clinical benefit of fenofibrate in patients with DR. The articles were selected from the PubMed database with the descriptors: [(fenofibrate) AND (“diabetic retinopathy”)], between 2010 and May 2025, fully available and free of charge and within the study categories: “clinical trial”, “meta-analysis” and “randomized clinical trial”. The articles demonstrate the benefit of fenofibrate use in reducing the progression of DR, highlighting evidence converging with the study "Fenofibrate Intervention and Event Lowering in Diabetes" (FIELD), the first study to demonstrate an association between fenofibrate use and prevention of invasive treatment for DR. The beneficial effects are mainly in mild to moderate DR and individuals with low haptoglobin (HP), requiring continuous treatment to maintain its effect.