Lowering Events in Non-proliferative Retinopathy in Scotland

Prior treatment

• Ongoing vitamin K antagonist (warfarin, phenindione, acenocoumarol), cyclosporine, colchicine, ketoprofen, daptomycin, fibrate therapy, or treatment with rosuvastatin 40mg daily
• Previous myositis, myopathy or rhabdomyolysis of any cause, or diagnosed hereditary muscle disorder
• Ongoing renal replacement therapy
• Any previous organ transplant
• Previous reported intolerance to any fibrate
• LENS participants can participate in other research studies, including clinical trials. The only exclusions related to co-enrolment will be: if any other study or trial excludes co-enrolment or if the intervention being investigated in another trial has the potential to interact with fenofibrate therapy.

Other illness

• History of gallbladder disease (cholecystitis, symptomatic gallstones, cholecystectomy)
• History of acute or chronic pancreatitis
• Cirrhosis of any aetiology or any other serious hepatic disease (investigator opinion)
• Medical history that might limit the individual's ability to take trial treatments for the duration of the study (e.g. severe respiratory disease, history of cancer within last 5 years other than non-melanoma skin cancer; or recent history of alcohol or substance misuse)
• Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participant at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial

Lab values

• Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \>2X the upper limit of normal (ULN) according to local NHS laboratory reference range at screening visit
• ALT or AST \>2.5X ULN according to local NHS laboratory reference range at randomisation visit
• Creatine kinase (CK) \>3X ULN according to local NHS laboratory reference range at screening visit
• CK \>3X ULN according to local NHS laboratory reference range at randomisation visit
• Estimated glomerular filtration rate (eGFR) \<40mL/min/1.73m2 at screening visit
• eGFR \<30mL/min/1.73m2 at randomisation visit

Other

• Clinically significant DR (defined as R3 or R4 or M2 in one or both eyes)
• Female who is pregnant, breastfeeding, currently trying to become pregnant, or of child-bearing potential and not practising birth control
• Not adherent to active run-in treatment

• Capable of giving informed consent
• Diabetes Mellitus (any type except gestational diabetes)
• Observable diabetic retinopathy/maculopathy (defined based on NHS Scotland grading criteria as: R1 in both eyes or R2 in one/both eyes at the most recent retinal screening assessment; or M1 in one/both eyes at any retinal screening assessment in the 3 years)
• Willing to either complete electronic questionnaires or conduct telephone interviews for collection of data once every 6 months