Long-term AREDS results show sustained treatment benefit for AMD

The long-term results of the multicenter Age-Related Eye Disease Study (AREDS) indicated that the beneficial effect of treatment with antioxidants and zinc with copper persisted 10 years after the AREDS 1 trial ended, said Emily Chew, MD.

AREDS is a prospective natural study history, the first phase of which ended in 2001. A total of 3,687 participants then were followed for 5 years to determine the progression to advanced age-related macular degeneration (AMD) and moderate vision loss, said Dr. Chew during Retina Subspecialty Day. She is deputy director, Division of Epidemiology and Clinical Research, National Eye Institute, Bethesda, MD.

Follow-up ended in December 2005, and the results for the participants with category 2, 3, and 4 disease (those with multiple small and nonextensive intermediate drusen, those with at least extensive intermediate drusen or large drusen with no evidence of advance AMD in either eye, and those with advanced AMD in one eye, respectively) who were at higher risk of progression were reported by Dr. Chew.

"At 10 years, in the placebo group, 44% of patients developed advanced AMD compared with 34% of patients who received the combination treatment consisting of antioxidant vitamins and zinc with copper," Dr. Chew said. "This translates into a 27% reduction in the risk of progression to advanced AMD."

The rate of moderate vision loss was also lower in the group randomized to combination treatment compared with the placebo group, 44% versus 56%, respectively.

The results also showed that there was no beneficial treatment effect on the early stages of AMD and did not prevent progression of drusen. There also is no increased in mortality in patients taking the AREDS formulation.

"The beneficial effect of this treatment supports the recommendation to consider the combination treatment of antioxidant vitamins and zinc with copper for patients with extensive intermediate drusen or large drusen in both eyes and patients with advanced AMD in one eye," Dr. Chew concluded. "The median treatment of 6.5 years appeared to continue to impart a protective effect 10 years later."