Fenofibrate for Prevention of DR Worsening
This randomized trial will evaluate the effect of fenofibrate compared with placebo for prevention of diabetic retinopathy (DR) worsening through 6 years of follow-up in eyes with mild to moderately severe non-proliferative DR (NPDR) and no CI-DME at baseline. In addition to evaluating efficacy, this study aims to evaluate the feasibility of a model for ophthalmologists to prescribe or collaborate with a primary care provider such as an internist/endocrinologist to prescribe and monitor the drug safely. If this study demonstrates that fenofibrate is effective for reducing the onset of proliferative diabetic retinopathy (PDR) or and the results are adopted by the community of retina specialists, a new strategy to prevent vision threatening complications of diabetes could be widely adopted. Widespread use of an oral agent effective at reducing worsening of DR would decrease the numbers of patients who undergo more invasive and much more expensive treatment for DR and who are consequently at risk for side effects that adversely affect visual function. This study will also assess the relationship of glycemic variability, as measured by continuous glucose monitoring with DR outcomes. Ancillary studies will characterize functional and structural outcomes in this cohort.
Conditions:
๐Ÿฆ  Diabetic Retinopathy
๐Ÿ—“๏ธ Study Start (Actual) 5 March 2021
๐Ÿ—“๏ธ Primary Completion (Estimated) April 2029
โœ… Study Completion (Estimated) April 2029
๐Ÿ‘ฅ Enrollment (Estimated) 560
๐Ÿ”ฌ Study Type INTERVENTIONAL
๐Ÿ“Š Phase PHASE3
Locations:
๐Ÿ“ Glendale, California, United States
๐Ÿ“ Huntington Beach, California, United States
๐Ÿ“ Loma Linda, California, United States
๐Ÿ“ Sacramento, California, United States
๐Ÿ“ San Francisco, California, United States
๐Ÿ“ Fort Myers, Florida, United States
๐Ÿ“ Jacksonville, Florida, United States
๐Ÿ“ Jacksonville, Florida, United States
๐Ÿ“ Lakeland, Florida, United States
๐Ÿ“ Orlando, Florida, United States
๐Ÿ“ Pinellas Park, Florida, United States
๐Ÿ“ Sarasota, Florida, United States
๐Ÿ“ Sarasota, Florida, United States
๐Ÿ“ Wesley Chapel, Florida, United States
๐Ÿ“ Augusta, Georgia, United States
๐Ÿ“ Marietta, Georgia, United States
๐Ÿ“ Sandy Springs, Georgia, United States
๐Ÿ“ Chicago, Illinois, United States
๐Ÿ“ Chicago, Illinois, United States
๐Ÿ“ Oak Park, Illinois, United States
๐Ÿ“ Indianapolis, Indiana, United States
๐Ÿ“ New Albany, Indiana, United States
๐Ÿ“ Hiawatha, Iowa, United States
๐Ÿ“ West Des Moines, Iowa, United States
๐Ÿ“ Overland Park, Kansas, United States
๐Ÿ“ West Monroe, Louisiana, United States
๐Ÿ“ Baltimore, Maryland, United States
๐Ÿ“ Ayer, Massachusetts, United States
๐Ÿ“ Boston, Massachusetts, United States
๐Ÿ“ Boston, Massachusetts, United States
๐Ÿ“ Detroit, Michigan, United States
๐Ÿ“ Grand Rapids, Michigan, United States
๐Ÿ“ Grand Rapids, Michigan, United States
๐Ÿ“ Minneapolis, Minnesota, United States
๐Ÿ“ Rochester, Minnesota, United States
๐Ÿ“ Columbia, Missouri, United States
๐Ÿ“ Saint Louis, Missouri, United States
๐Ÿ“ Liverpool, New York, United States
๐Ÿ“ New York, New York, United States
๐Ÿ“ Rochester, New York, United States
๐Ÿ“ Shirley, New York, United States
๐Ÿ“ Chapel Hill, North Carolina, United States
๐Ÿ“ Cleveland, Ohio, United States
๐Ÿ“ Oklahoma City, Oklahoma, United States
๐Ÿ“ Eugene, Oregon, United States
๐Ÿ“ Portland, Oregon, United States
๐Ÿ“ Salem, Oregon, United States
๐Ÿ“ Springfield, Oregon, United States
๐Ÿ“ Monroeville, Pennsylvania, United States
๐Ÿ“ Sewickley, Pennsylvania, United States
๐Ÿ“ Knoxville, Tennessee, United States
๐Ÿ“ Nashville, Tennessee, United States
๐Ÿ“ Austin, Texas, United States
๐Ÿ“ Austin, Texas, United States
๐Ÿ“ Bellaire, Texas, United States
๐Ÿ“ Houston, Texas, United States
๐Ÿ“ Lubbock, Texas, United States
๐Ÿ“ San Antonio, Texas, United States
๐Ÿ“ Seattle, Washington, United States
๐Ÿ“ La Crosse, Wisconsin, United States

๐Ÿ“‹ Eligibility Criteria

Description

  • Key Inclusion Criteria
  • * Age โ‰ฅ18 years and \< 80 years.
  • * Type 1 or type 2 diabetes.
  • * At least one eye with the following:
  • * Mild to moderately severe NPDR (defined by ETDRS DR severity level 35 to 47), confirmed by central Reading Center grading of fundus photographs.
  • * Best-corrected E-ETDRS visual acuity letter score of โ‰ฅ74 (approximate Snellen equivalent 20/32 or better). If best corrected letter score is 74-78, investigator must verify that vision loss is not due to the presence of CI-DME, cataract, or other condition that may affect visual acuity during the course of the study.
  • * If only one eye is eligible, the non-study eye must have at least microaneurysms only (DR severity level 20)
  • Key Exclusion Criteria
  • Eye-level exclusion criteria (the eye is ineligible if any of the following is met):
  • * Current CI-DME based on clinical exam or OCT central subfield thickness (CST)
  • * Zeiss Cirrus: CST โ‰ฅ290 ยตm in women or โ‰ฅ 305 ยตm in men
  • * Heidelberg Spectralis: CST โ‰ฅ305 ยตm in women or โ‰ฅ320 ยตm in men
  • * Any prior treatment for DME or DR, other than focal/grid laser. If the eye has a history of focal/grid laser, it must be at least 12 months prior.
  • * History of intraocular anti-VEGF or corticosteroid treatment within the prior year for any indication
  • Participant-level exclusion criterion (the participant is ineligible if the following criterion is met):
  • โ€ข Decreased renal function, defined as requiring dialysis or central laboratory eGFR value \< 45 mL/min/1.73 m2
Ages Eligible for Study: 18 Years to 80 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No

๐Ÿ—“๏ธ Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

  • First Submitted 3 December 2020
  • First Submitted that Met QC Criteria 3 December 2020
  • First Posted 10 December 2020

Study Record Updates

  • Last Update Submitted that Met QC Criteria 25 March 2024
  • Last Update Posted 27 March 2024
  • Last Verified March 2024