Summarizing the FIELD study: lessons from a ‘negative' trial

Abstract

Introduction: Disturbances in lipid metabolism represent an integral component of dysglycemic states and may increase the risk of diabetic complications. Although from a pathophysiological viewpoint fibrates could represent the ideal drug for patients with diabetic dyslipidemia the evidence that support their use in these patients remains elusive. The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study was a double-blind, placebo-controlled trial that randomized 9795 diabetic subjects to fenofibrate or matching placebo for an average of 5 years.

Areas covered: In this review, all the findings of the FIELD trial are summarized.

Expert opinion: Chronic kidney disease (reduced GFR, albuminuria or both) and the presence of metabolic syndrome significantly increase the cardiovascular risk in patients with diabetes. Fenofibrate may represent a useful therapeutic option for the treatment of atherogenic dyslipidemia in diabetic subjects. Further attention should be paid on the unique microvascular-protecting properties of the drug.

Keywords::

• atherogenic dyslipidemia
• diabetes
• fenofibrate
• nephropathy
• retinopathy

Declaration of interest

V Tsimihodimos, D Mikhalidis and M Elisaf have given talks, attended conferences and participated in trials and advisory boards sponsored by various pharmaceutical companies, including Astra-Zeneca, Abbott and Merck Sharpe and Dohme (MSD).