FIELD substudy shows no influence by metformin or sulfonylurea on fenofibrate effects on CVD risks
December - 5 - 2011
The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study investigated the efficacy of fenofibrate on cardiovascular (CVD) outcomes in type 2 diabetes (T2DM). In a substudy, the interrelationships between metformin or sulfonylurea (first-line treatments for oral antidiabetic drugs [OADs] for T2DM) monotherapy and metabolic risk factors, cardiovascular risk outcomes, and the effect of each treatment on the risk-modifying effect of fenofibrate. A total of 6,005 FIELD-enrolled subjects were included in the substudy, and all were on metformin or sulfonylurea monotherapy or diet therapy alone and not on insulin at study entry. Stratification according to therapy type showed different subject characteristics. Metformin users tended to be younger, female or obese and have poor lipid profiles and elevated homocysteine levels. Patients on sulfonylurea had longer disease duration, more cardio- and microvascular comorbidities, and higher creatinine and lower HDL cholesterol levels. Diet alone was significantly associated with lower CVD outcomes risk than sulfonylurea but was nonsignificant after adjusting for confounding disease factors (duration, intensity and other CVD factors). The two OADs did not have a significant impact on prevention of CVD or the CVD-protective effects of fenofibrate during the trial (Sullivan, D. et al. Diabetes Res Clin Pract 2011, 94(2): 284).