Singapore (Commonwealth Union)_ Singaporean researchers have discovered that fenofibrate, a medicine used to treat high blood fat and high cholesterol, might also potentially treat a diabetic-related eye disease that may result in blindness. In moderate cases, diabetic corneal neuropathy, which is estimated to affect between 47% and 64% of diabetic individuals, causes eye discomfort and diminished corneal sensation. This happens when high blood sugar levels damage and inflame nerves in the cornea, which is the transparent layer of the eye that protects the iris and pupil.
This condition is often misdiagnosed and recognized only in rare cases when symptoms are severe, for instance, when patients report corneal sores that do not heal, corneal infections, or perforations that might result in blindness. In addition to lubricants and anti-inflammatory eye drops that help patients manage symptoms, there are no local therapies for the illness at this time. However, this scenario may change soon, as 15 researchers from four institutions, namely the Singapore Eye Research Institute (Seri), Singapore National Eye Centre (SNEC), Singapore General Hospital (SGH), and Duke-NUS Medical School, conducted a 30-day study of fenofibrate on 30 individuals.
After administering 100 mg to 300 mg of the medicine daily to patients, researchers discovered that it improved the condition of the corneal nerves. In November 2022, the results of the experiment were published in the journal Diabetes. According to Associate Professor Liu Yu-Chi, a clinician scientist at SNEC and Seri who was the head of the study, “Fenofibrate was observed to help the patients in the trial through three ways: By reducing the inflammation and clotting of nerves in the cornea, by providing nutrition to the nerves in order to enable them to regenerate, and by regulating the metabolism of lipids in our body to lower lipid levels, which is a known risk factor for diabetic neuropathy.”
According to Dr Tan Hong Chang, co-author of the research and a senior consultant at SGH’s department of endocrinology, “For patients with diabetic corneal neuropathy, their corneal nerves are not healthy and tend to be fewer in number. The arrangement of the cells on the corneal surface is also disorganized”. He added, “In this trial, we observed that fenofibrate was able to reverse these abnormalities, indicating that the nerves become healthier.” The medication is quite affordable. A 200mg tablet of the medicine costs between 85 cents and $1.10 in Singapore, but the nerve growth factor eye drop, a relatively new treatment that has been licensed in Europe and the United States, costs between $11,000 and $63,000 each month. According to Professor Thomas Coffman, dean of the Duke-NUS Medical School, the discovery gives hope for an economical and safe medication that can preserve people’s eyesight, and promises to be a substantial step in the continuing struggle against diabetes.
Further, the researchers will test the medicine in randomized controlled trials with a minimum of 200 patients in order to validate their results and determine the appropriate dosage and length of treatment. Diabetic eye disease refers to a group of eye conditions that people with diabetes may develop as a result of high blood sugar levels over an extended period of time. These conditions can include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma. If left untreated, diabetic eye disease can lead to severe vision loss or even blindness. Therefore, it is essential for individuals with diabetes to receive regular eye exams to monitor and manage any potential eye problems that may arise. In this way, early detection and intervention can help prevent or slow down the progression of diabetic eye disease, preserving the person’s vision and quality of life.
