Abstract
Abstract: :
Purpose: To translate the results of treatment efficacy in AREDS into implications for US public health. Methods: AREDS included 2 clinical trials: high-dose antioxidant and/or zinc supplements to delay development of advanced AMD, and to delay progression of cataract. 4,757 participants age 55-80 at various levels of risk of developing advanced AMD were enrolled in the trials at 11 US clinical centers and randomized to receive daily tablets of antioxidants (vitamins C and E and beta carotene), zinc (with copper), antioxidants plus zinc, or placebo. After median follow-up of 6.3 years, the treatments were not effective for cataract. However, antioxidants plus zinc significantly reduced the risk of development of advanced AMD by 25% in participants at moderate risk of advanced AMD. The Eye Disease Prevalence Study Group has developed provisional US prevalence data for AMD, based on US census data and meta analysis of local and regional prevalence reports. AREDS treatment effect data are applied to US prevalence data to yield estimates of the potential number of persons with AMD whose progression to advanced AMD would be delayed by use of the AREDS supplements. Results: An estimated 6 million Americans age 55-80 are at high risk for developing advanced AMD (fellow eyes of persons with neovascular AMD, or geographic atrophy in one eye, or intermediate AMD (large drusen) in one or both eyes). Based on AREDS risk estimates, about 1.2 million of this group are likely to develop advanced AMD in the coming 5 years. If all of these people took the antioxidant plus zinc AREDS daily supplement, the 25% risk reduction over 5 years would result in more than three hundred thousand people spared from progression to advanced AMD during this time. Conclusion: The reduced risk of developing advanced AMD following use of the AREDS supplements in persons at high risk for developing advanced AMD has a large public health impact.
Keywords: 308 age-related macular degeneration • 357 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 351 clinical (human) or epidemiologic studies: health care delivery/economics/manpower