Antidiabetic Action of Bezafibrate in a Large Observational Database
- James H Flory, BA (jflory{at}mail.med.upenn.edu)*,
- Susan Ellenberg, PhD*,
- Philippe O Szapary, MD, MSCE*†,¥,
- Brian L Strom, MD MPH* and
- Sean Hennessy, PharmD, PhD*
- *Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19103 (all authors)
- †Centocor Research and Development, Malvern, PA 19355
- ¥Preventive Cardiovascular Medicine and Lipid Clinic, Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA 19104
Abstract
Objective: To test the hypothesis that bezafibrate, an approved fibrate, can prevent or delay type 2 diabetes.
Research Design and Methods: Retrospective cohort study using data from routine medical practice in the United Kingdom, as captured by the General Practitioner's Research Database (GPRD). Individuals chronically exposed to bezafibrate were compared to individuals chronically exposed to other fibrates. Hazard ratios for incident type 2 diabetes mellitus were calculated using a Cox proportional hazards model. A post-hoc analysis examined bezafibrate's effect 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 pre-existing diabetes also showed lower hazard for progression to use of antidiabetic medication (HR 0.54, 95% CI 0.38, 0.76) or progression to use of insulin (HR 0.78, 95% CI 0.55, 1.10).
Conclusions: Bezafibrate appears to have clinically important antidiabetic properties. Randomized controlled trials should be considered to assess bezafibrate's utility in treating patients with diabetes or in preventing diabetes in high risk patients.
Footnotes
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- Received October 2, 2008.
- Accepted January 4, 2009.
- Copyright © American Diabetes Association
