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R.C. Milton, T.E. Clemons, R.D. Sperduto, B.E. K. Klein, AREDS Research Group; Centrum Use and Progression of Age–related Cataract in the Age–Related Eye Disease Study (AREDS) – A Propensity Score Approach . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3416.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the effect of Centrum on the development and progression of age–related lens opacities. Methods: The 11–center Age–Related Eye Disease Study (AREDS) included a randomized clinical trial of the effect of high–dose supplementation of selected antioxidants on the progression of lens opacity. No effect of this intervention was observed. AREDS participants who desired a one–a–day multivitamin supplement were provided with Centrum, an RDA–dosage supplement. Baseline and annual (starting in year 2) lens photographs were graded at a reading center for the severity of lens opacity using the AREDS cataract grading scale. Progression of type–specific lens opacity was defined as in the clinical trial (Arch Ophthalmol 2001;119:1417–36). Because use of Centrum was elective and therefore not randomized, a propensity score analysis was performed. A logistic regression model using 14 baseline characteristics was used to generate a propensity score for Centrum use for 4,590 AREDS participants with at least one natural lens present. Repeated–measures logistic regression was used to evaluate the relationship of Centrum use and progression of lens opacity adjusted for propensity score. Results: 66% of the AREDS participants elected to supplement with Centrum. In an unadjusted logistic regression Centrum use was associated with a reduction in lens opacity progression (OR, 0.88; 95% CI, 0.79–0.98; P=0.022). The propensity for Centrum use was determined without regard to outcome. The model yielded a c–statistic of 0.86, indicating a strong ability to differentiate between Centrum users and nonusers. After adjusting for propensity score, Centrum use was associated with a reduction in progression to lens opacity (OR, 0.81; 95% CI, 0.70–0.94; P=0.006). The association remained present after further adjustment for baseline covariates age, gender, race, smoking status, education, and AMD category (OR, 0.82; 95% CI, 0.70–0.95; P=0.007). Conclusion: This multicenter observational analysis of Centrum within AREDS suggests an association between Centrum use and lens opacity progression. The NEI is currently supporting a randomized clinical trial to assess the effect of Centrum use on the development of lens opacities.
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