Update and summary on AREDS2

The AREDS2 report has recently been published with important implications for those afflicted with early stage AMD.

In summary, AREDS2 recruited 4203 volunteers with the non-advanced form of AMD, and all subjects received broad-spectrum antioxidants (vitamin C, vitamin E, beta-carotene, zinc and copper [AREDS1 formulation or variations thereof]) with additional treatment of lutein (L) and zeaxanthin (Z) (Treatment 1), or omega-3 fatty acids (Treatment 2), or L and Z and omega-3 fatty acids (Treatment 3), or placebo.

In brief, the AREDS 2 investigators reported:

• No statistically significant extra benefit (reduction in risk of progression to advanced AMD) for any of the Treatments 1-3 compared to placebo.
• A statistically significant (p = 0.01) reduction of 9% in risk of progression to advanced AMD for subjects receiving L and Z when compared with subjects not receiving L and Z.
• Participants with lowest dietary intake of L and Z showed a statistically significant (p = 0.01) reduction of 26% in risk of progression to advanced AMD for subjects receiving L and Z when compared with subjects not receiving L and Z.
• A statistically significant (p = 0.02) reduction of 18% in risk of progression to advanced AMD for subjects receiving L and Z (plus an AREDS formulation) in the absence of beta carotene, when compared with subjects receiving an AREDS formulation with beta carotene (and not receiving L and Z).
• A statistically significant (p = 0.01) reduction of 26% in risk of profound visual loss (i.e., neovascular AMD) for subjects receiving L and Z (plus an AREDS formulation) in the absence of beta carotene, when compared with subjects receiving an AREDS formulation with beta carotene (and not receiving L and Z).
• Beta carotene was associated with poor absorption of L and Z, with consequentially reduced bioavailability of these carotenoids.
• The inclusion of beta carotene in the formulation was associated with increased risk of lung cancer amongst current and past smokers.
• There was no evidence that supplementation with omega-3 fatty acids was of benefit in any of the analyses reported in this study.
• Supplementation with L and Z, omega-3 fatty acids or beta carotene had no statistically significant effect on visual acuity.
• Supplementation with L and Z, omega-3 fatty acids or beta carotene had no statistically significant effect on mortality.

This summary was created by Professor John Nolan, PhD, Principal Investigator, Fulbright Scholar, Howard Fellow, ERC Fellow, Macular Pigment Research Group, Vision Research Centre, Waterford Institute of Technology, Ireland.

A more detailed summary will be published in an upcoming print issue of Ophthalmology Times Europe.