Journal article
Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3
JAMA ophthalmology, Vol.132(2), pp.142-149
02/2014
DOI: 10.1001/jamaophthalmol.2013.7376
PMCID: PMC4636082
PMID: 24310343
Abstract
The Age-Related Eye Disease Study (AREDS) formulation for the treatment of age-related macular degeneration (AMD) contains vitamin C, vitamin E, beta carotene, and zinc with copper. The Age-Related Eye Disease Study 2 (AREDS2) assessed the value of substituting lutein/zeaxanthin in the AREDS formulation because of the demonstrated risk for lung cancer from beta carotene in smokers and former smokers and because lutein and zeaxanthin are important components in the retina. To further examine the effect of lutein/zeaxanthin supplementation on progression to late AMD. The Age-Related Eye Disease Study 2 is a multicenter, double-masked randomized trial of 4203 participants, aged 50 to 85 years, at risk for developing late AMD; 66% of patients had bilateral large drusen and 34% had large drusen and late AMD in 1 eye. In addition to taking the original or a variation of the AREDS supplement, participants were randomly assigned in a factorial design to 1 of the following 4 groups: placebo; lutein/zeaxanthin, 10 mg/2 mg; omega-3 long-chain polyunsaturated fatty 3 acids, 1.0 g; or the combination. S Documented development of late AMD by central, masked grading of annual retinal photographs or by treatment history. RESULTS In exploratory analysis of lutein/zeaxanthin vs no lutein/zeaxanthin, the hazard ratio of the development of late AMD was 0.90 (95% CI, 0.82-0.99; P = .04). Exploratory analyses of direct comparison of lutein/zeaxanthin vs beta carotene showed hazard ratios of 0.82 (95% CI, 0.69-0.96; P = .02) for development of late AMD, 0.78 (95% CI, 0.64-0.94; P = .01) for development of neovascular AMD, and 0.94 (95% CI, 0.70-1.26; P = .67) for development of central geographic atrophy. In analyses restricted to eyes with bilateral large drusen at baseline, the direct comparison of lutein/zeaxanthin vs beta carotene showed hazard ratios of 0.76 (95% CI, 0.61-0.96; P = .02) for progression to late AMD, 0.65 (95% CI, 0.49-0.85; P = .002) for neovascular AMD, and 0.98 (95% CI, 0.69-1.39; P = .91) for central geographic atrophy. The totality of evidence on beneficial and adverse effects from AREDS2 and other studies suggests that lutein/zeaxanthin could be more appropriate than beta carotene in the AREDS-type supplements. clinicaltrials.gov Identifier: NCT00345176.
Details
- Title: Subtitle
- Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3
- Creators
- Emily Y Chew - Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, MarylandTraci E Clemons - EMMES Corp, Rockville, MarylandJohn Paul Sangiovanni - National Eye Institute, Clinical Trials Branch, Bethesda, MarylandRonald P Danis - Department of Ophthalmology, University of Wisconsin-MadisonFrederick L Ferris III - National Eye InstituteMichael J Elman - Elman Retina Group, Baltimore, MarylandAndrew N Antoszyk - Charlotte Eye Ear Nose and Throat, Charlotte, North CarolinaAlan J Ruby - Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MichiganDavid Orth - Ingalls Memorial Hospital, Harvey, IllinoisSusan B Bressler - Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MarylandGary E Fish - Texas Retina Associates, Dallas, TexasGeorge Baker Hubbard - Emory University, Atlanta, GeorgiaMichael L Klein - Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, PortlandSuresh R Chandra - Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public HealthBarbara A Blodi - Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health15Fundus Photograph Reading Center, University of Wisconsin-MadisonAmitha Domalpally - Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public HealthThomas Friberg - Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PennsylvaniaWai T Wong - Unit on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MarylandPhilip J Rosenfeld - Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FloridaElvira Agrón - National Eye Institute, Bethesda, MarylandCynthia A Toth - Duke University Medical Center, Durham, North CarolinaPaul S Bernstein - Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah Health Sciences Center, University of Utah, Salt Lake CityRobert D Sperduto - EMMES Corp, Rockville, MarylandAge-Related Eye Disease Study 2 (AREDS2) Research Group
- Contributors
- James C Folk (Contributor) - University of Iowa, Ophthalmology and Visual SciencesStephen R Russell (Contributor) - University of Iowa, Ophthalmology and Visual SciencesHeather A Stockman (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
- Resource Type
- Journal article
- Publication Details
- JAMA ophthalmology, Vol.132(2), pp.142-149
- DOI
- 10.1001/jamaophthalmol.2013.7376
- PMID
- 24310343
- PMCID
- PMC4636082
- NLM abbreviation
- JAMA Ophthalmol
- ISSN
- 2168-6165
- eISSN
- 2168-6173
- Publisher
- United States
- Grant note
- HHS-N-260-2005-00007-C / PHS HHS R01 EY021532 / NEI NIH HHS N01-EY-5-0007 / NEI NIH HHS ZIA EY000485-07 / Intramural NIH HHS
- Language
- English
- Date published
- 02/2014
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9983979975902771
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