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Titolo:
A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss - AREDS Report No. 8
Autore:
Kassoff, A; Kassoff, J; Buehler, J; Eglow, M; Kaufman, F; Mehu, M; Kieval, S; Mairs, M; Graig, B; Quattrocchi, A; Jones, D; Locatelli, J; Ruby, A; Capone, A; Garretson, B; Hassan, T; Trese, MT; Williams, GA; Regan, V; Manatrey, P; Streasick, P; Szydlowski, L; McIver, F; Bridges, C; Stanley, C; Cumming, K; Lewis, B; Zajechowski, M; Margherio, RR; Cox, MS; Camille, J; Falk, R; Siedlak, P; Neubert, C; Klein, ML; Stout, JT; OMalley, A; Lauer, AK; Robertson, JE; Wilson, DJ; Beardsley, C; Anderson, H; Wallace, P; Smith, G; Howard, S; Dreyer, RF; Ma, C; Chenoweth, RG; Zilis, JD; Johnson, M; Rice, P; Daniel, H; Crider, H; Parker, S; Sherman, K; Martin, DF; Aaberg, TM; Sternberg, P; Curtis, LT; Ju, B; Gilman, J; Myles, B; Strittman, S; Gentry, C; Yi, H; Capone, A; Lambert, M; Meredith, T; Aaberg, TM; Saperstein, D; Lim, JI; Stribling, B; Armiger, D; Swords, R; Orth, DH; Flood, TP; Civantos, J; deBustros, S; Packo, KH; Merrill, PT; Cohen, JA; Figliulo, C; Morrison, C; Bryant, DA; Doherty, D; McVicker, M; Drefcinski, T; Seddon, JM; Pinnolis, MK; Davis, N; Burton, I; Taitsel, T; Walsh, D; Dubois-Moran, J; Callahan, C; Evans, C; Snow, KK; Jones-Devonish, DA; Crouse, VD; Rosenberg, NJ; Chew, EY; Csaky, K; Ferris, FL; Shimel, KH; Woods, MA; Kuehl, EM; Ciatto, PF; Palmer, M; Babilonia-Ayukawa, G; Foster, GE; Goodman, L; Kim, YJ; Kivitz, IJ; Koutsandreas, D; LaReau, A; Mercer, RF; Nashwinter, R; McCarthy, SA; Ayres, LM; Lopez, P; Randalls, A; Friberg, TR; Eller, AW; Gorin, MB; Nixon, S; Mack, B; Curtin, DY; Ostroska, PP; Fijewski, E; Alexander, J; Paine, MK; Corbin, PS; Warnicki, J; Bressler, SB; Bressler, NM; Cassel, G; Finkelstein, D; Goldberg, M; Haller, JA; Ratner, L; Schachat, AP; Sherman, SH; Sunness, JS; Schenning, S; Sackett, C; Cain, D; Emmert, D; Herring, M; McDonald, J; Falk, R; Wheeler, S; Mcmillan, M; George, T; Elman, MJ; Ballinger, R; Betancourt, A; Glasser, D; Herr, M; Hirsh, D; Kilingsworth, D; Kohlhepp, P; Lammlein, J; Raden, RZ; Seff, R; Shuman, M; Starr, J; Carrigan, A; Sotirakos, P; Cain, T; Mathews, T; Ringrose, C; Chandra, SR; Gottlieb, JL; Ip, MS; Klein, R; Nork, TM; Stevens, TS; Blodi, BA; Altaweel, M; Klein, BEK; Olson, M; Soderling, B; Blatz, M; Perry-Raymond, JR; Burke, K; Knutson, G; Peterson, J; Krolnik, D; Harrison, R; Somers, G; Myers, FL; Wallow, I; Olsen, TW; Bresnik, G; De Venecia, G; Perkins, T; Walker, W; Miller, JL; Neider, M; Wabers, HD; Weber, G; Myers, HEL; Davis, MD; Klein, BEK; Klein, R; Hubbard, L; Neider, M; Wabers, HD; Magli, YL; Ansay, S; Armstrong, J; Lang, K; Badal, D; Geithman, PL; Miner, KD; Dohm, KL; Esser, B; Hurtenbach, C; Craanen, S; Webster, M; Elledge, J; Reed, S; Benz, W; Reimers, J; Fisher, MR; Gangnon, R; King, W; Gai, CY; Baliker, J; Carr, A; Osterby, K; Kastorff, L; Robinson, N; Onofrey, J; Glander, KE; Brickbauer, J; Miller, D; Sowell, A; Gunter, E; Bowman, B; Lindblad, AS; Milton, RC; Clemons, TE; Ederer, F; Gensler, G; Henning, A; Entler, G; McBee, W; Roberts, K; Stine, E; Berlin, SH; Tomlin, K; Pallas, S; Scholl, PR; Mengers, SA; Anand, R; Ferris, FL; Sperduto, RD; Kurinij, N; Chew, EY;
Indirizzi:
Eye Ctr Mem, Albany, NY USA Eye Ctr Mem Albany NY USAEye Ctr Mem, Albany, NY USA Emory Univ, Atlanta, GA 30322 USA Emory Univ Atlanta GA USA 30322Emory Univ, Atlanta, GA 30322 USA Ingalls Mem Hosp, Harvey, IL USA Ingalls Mem Hosp Harvey IL USAIngalls Mem Hosp, Harvey, IL USA Massachusetts Eye & Ear Infirm, Boston, MA 02114 USA Massachusetts Eye & Ear Infirm Boston MA USA 02114 , Boston, MA 02114 USA NEI, Ctr Clin, Bethesda, MD 20892 USA NEI Bethesda MD USA 20892NEI, Ctr Clin, Bethesda, MD 20892 USA Univ Pittsburgh, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USAUniv Pittsburgh, Pittsburgh, PA USA Johns Hopkins Med Inst, Baltimore, MD 21205 USA Johns Hopkins Med Inst Baltimore MD USA 21205 st, Baltimore, MD 21205 USA Elman Retina Grp PA, Baltimore, MD USA Elman Retina Grp PA Baltimore MD USA an Retina Grp PA, Baltimore, MD USA Univ Wisconsin, Reading Ctr, Madison, WI USA Univ Wisconsin Madison WI USA iv Wisconsin, Reading Ctr, Madison, WI USA Ctr Dis Control & Prevent, Cent Lab, Atlanta, GA USA Ctr Dis Control & Prevent Atlanta GA USA vent, Cent Lab, Atlanta, GA USA NEI, Project Off, Bethesda, MD 20892 USA NEI Bethesda MD USA 20892NEI, Project Off, Bethesda, MD 20892 USA
Titolo Testata:
ARCHIVES OF OPHTHALMOLOGY
fascicolo: 10, volume: 119, anno: 2001,
pagine: 1417 - 1436
SICI:
0003-9950(200110)119:10<1417:ARPCTO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLUE MOUNTAINS EYE; BEAVER DAM EYE; VISUAL IMPAIRMENT; ORAL ZINC; MACULOPATHY; ANTIOXIDANT; PREVALENCE; PIGMENT; COHORT; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Kassoff, A Eye Ctr Mem, Albany, NY USA Eye Ctr Mem Albany NY USAEye Ctr Mem, Albany, NY USA
Citazione:
A. Kassoff et al., "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss - AREDS Report No. 8", ARCH OPHTH, 119(10), 2001, pp. 1417-1436

Abstract

Background: Observational and experimental data suggest that antioxidant and/or zinc supplements may delay progression of age-related macular degeneration (AMD) and vision loss. Objective: To evaluate the effect of high-dose vitamins C and E, beta carotene, and zinc supplements on AMD progression and visual acuity. Design: The Age-Related Eye Disease Study, an 11-center double-masked clinical trial, enrolled participants in an AMD trial if they had extensive small drusen, intermediate drusen, large drusen, noncentral geographic atrophy, or pigment abnormalities in 1 or both eyes, or advanced AMD or vision loss due to AMD in 1 eye. At least 1 eye had best-corrected visual acuity of 20/32 or better. Participants were randomly assigned to receive daily oral tablets containing: (1) antioxidants (vitamin C, 500 mg; vitamin E, 400 IU; and beta carotene, 15 mg) (2) zinc, 80 mg, as zinc oxide and copper, 2 mg, as cupric oxide; (3) antioxidants plus zinc; or (4) placebo. Main Outcome Measures: (1)Photographic assessment of progression to or treatment for advanced AMD and (2) at least moderate visual acuity loss from baseline ( : 15 letters). Primary analyses used repeated-measures logistic regression with a significance level of .01, unadjusted for covariates. Serum level measurements, medical histories, and mortality rates were used for safety monitoring. Results: Average follow-up of the 3640 enrolled study participants, aged 55-80 years, was 6.3 years, with 2.4% lost to follow-up. Comparison with placebo demonstrated a statistically significant odds reduction for the development of advanced AMD with antioxidants plus zinc (odds ratio [OR], 0.72; 99% confidence interval [CI], 0.52-0.98). The ORs for zinc alone and antioxidants alone are 0.75 (99% CI, 0.55-1.03) and 0.80 (99% CI, 0.59-1.09), respectively. Participants with extensive small drusen, nonextensive intermediate size drusen, or pigment abnormalities had only a 1.3% 5-year probabilityof progression to advanced AMD. Odds reduction estimates increased when these 1063 participants were excluded (antioxidants plus zinc: OR, 0.66; 99% CI, 0.47-0.91; zinc: OR, 0.71; 99% CI, 0.52-0.99; antioxidants: OR, 0.76; 99% CI, 0.55-1.05). Both zinc and antioxidants plus zinc significantly reduced the odds of developing advanced AMD in this higher-risk group. The only statistically significant reduction in rates of at least moderate visual acuity loss occurred in persons assigned to receive antioxidants plus zinc (OR, 0.73; 99% CI, 0.54-0.99). No statistically significant serious adverse effect was associated with any of the formulations. Conclusions: Persons older than 55 years should have dilated eye examinations to determine their risk of developing advanced AMD. Those with extensive intermediate size drusen, at least 1 large druse, noncentral geographic atrophy in 1 or both eyes, or advanced AMD or vision loss due to AMD in 1 eye, and without contraindications such as smoking, should consider taking a supplement of antioxidants plus zinc such as that used in this study.

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Documento generato il 14/08/20 alle ore 04:09:35