Specialist: Original AREDS formulation still best option for non-smokers
LISBON, Portugal — Because there are no safety issues in non-smokers exposed to beta-carotene, there is no reason why these patients should be switched to the AREDS2 formulation from the original AREDS formulation, according to one speaker at the Controversies in Ophthalmology meeting.
In response to studies reporting an association between beta-carotene and increased risk of mortality and lung cancer, AREDS participants who were current smokers were reassigned to a formulation that did not contain beta-carotene.
“At the conclusion of the AREDS, no increase in mortality or lung cancer was found in the antioxidant arm in spite of the high doses of beta-carotene. AREDS did not identify any adverse effect of the original formula that were specific to non-smokers,” Susan B. Bressler, MD, said.
Susan B. Bressler
AREDS2 suggested an alternative formulation, suitable for smokers and non-smokers, in which beta-carotene was substituted with lutein/zeaxanthin.
However, “the primary outcome of AREDS2 was not met. None of the vision outcomes suggested any favorable effect,” Bressler said. “The AREDS2 formulation may not be just as good as AREDS, particularly where vision is concerned.”
On the other hand, the original AREDS formula has more than 10 years of trial evidence supporting efficacy and safety.
“In my opinion, the strength of the evidence in support of the original formulation in terms of efficacy is greater than for AREDS2, and there are no safety concerns in regard to non-smokers,” Bressler said.
Disclosure: Bressler has received grant/research support form Notal Vision, Genentech, Novartis, Bausch + Lomb and Regeneron.