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  • Long-Term Outcomes of Revised AREDS2 Supplement

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, July 2022

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    Chew et al. set out to assess the 10-year risk of developing lung cancer and late age-related macular degeneration (AMD) in participants of the Age-Re­lated Disease Study 2 (AREDS2). They found that while the development of lung cancer nearly doubled in former smokers who took the supplement with beta carotene, participants who took the version with lutein/zeaxanthin were not at increased risk of developing lung cancer. In addition, the researchers found that lutein/zeaxanthin was asso­ciated with a reduced risk of progres­sion to late AMD.

    For this follow-up study, the re­searchers evaluated 3,882 participants (6,351 eyes) of the original 4,203 pa­tients in the AREDS2 cohort. The par­ticipants’ mean age at baseline was 72 years, and 2,240 (57.7%) were women. Most self-identified as White (97.1%) or non-Hispanic (98.1%) individuals.

    During the original study, partic­ipants were randomized to receive lutein/zeaxanthin and/or omega-3 fatty acids or placebo and, secondarily, to beta carotene versus no beta carotene and to high versus low doses of zinc. In this follow-up study, all participants received the AREDS2 supplements that had no beta carotene but did have lutein/zeaxanthin, vitamins C and E, and zinc plus copper. Outcomes were assessed every six months via telephone calls, and analyses of AMD progression and lung cancer development were conducted using proportional hazards regression and logistic regression, respectively.

    During the full 10-year study period, 117 participants developed lung cancer, and 2,040 of the study eyes (48%) developed late AMD (the subtypes were un­known). At the 10-year mark, the odds ratio of having lung cancer was 1.82 for those randomly assigned to beta carotene and .91 for those who received lutein/zeaxanthin. When outcomes of lutein/zeaxanthin were compared to no lutein/zeaxanthin, the hazard ratio (HR) for progression to late AMD was .91. An analysis of lutein/zeaxanthin to beta carotene found that the HR for late AMD was .85.

    These results provide further sup­port for the addition of lutein/zeaxan­thin to—and removal of beta carotene from—the AREDS2 supplement, the researchers said. Not only did former smokers in the lutein/zeaxanthin group have a lower risk of lung cancer, but the addition of lutein and zeaxanthin also appeared to be associated with a decreased risk of progression to late AMD.

    The original article can be found here.