Antidiabetic Action of Bezafibrate in a Large Observational Database
- James H. Flory1,
- Susan Ellenberg, PHD1,
- Philippe O. Szapary, MD, MSCE1,2,
- Brian L. Strom, MD, MPH1 and
- Sean Hennessy, PHARMD, PHD1
- 1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;
- 2Centocor Research and Development, Malvern, Pennsylvania, and Preventive Cardiovascular Medicine and Lipid Clinic, Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
- Corresponding author: James Flory, jflory{at}mail.med.upenn.edu.
Abstract
OBJECTIVE The purpose of this study was to test the hypothesis that bezafibrate, an approved fibrate, can prevent or delay type 2 diabetes.
RESEARCH DESIGN AND METHODS This was a retrospective cohort study using data from routine medical practice in the U.K., as captured by the General Practice Research Database (GPRD). Individuals chronically exposed to bezafibrate were compared with individuals chronically exposed to other fibrates. Hazard ratios (HRs) for incident type 2 diabetes were calculated using a Cox proportional hazards model. A post hoc analysis was used to examine the effect of bezafibrate on progression to use of oral antidiabetic medications or insulin in individuals with diabetes at baseline.
RESULTS Bezafibrate users had a lower hazard for incident diabetes than users of other fibrates (HR 0.66 [95% CI 0.53–0.81]). This effect became stronger with increasing duration of therapy. Post hoc analysis of the effect of bezafibrate on progression of preexisting diabetes also showed a lower hazard for progression to use of antidiabetic medication (0.54 [0.38–0.76]) or progression to use of insulin (0.78 [0.55–1.10]).
CONCLUSIONS Bezafibrate appears to have clinically important antidiabetic properties. Randomized controlled trials should be considered to assess the utility of bezafibrate in treating patients with diabetes or in preventing diabetes in high-risk patients.
Footnotes
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No sponsor had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received October 2, 2009.
- Revision received January 4, 2009.
- © 2009 by the American Diabetes Association.
