COMMENTARY

AREDS2: No Cure, but Not a Failure

Brianne N. Hobbs, OD

Disclosures

June 11, 2013

Viewpoint

The results of the AREDS2 trial could plausibly be viewed as disappointing, because 2 seemingly promising supplements, carotenoids and omega 3 fatty acids, were exposed as ineffective in reducing the risk for progression to advanced AMD. Both lutein and zeaxanthin, and EPA and DHA, generated positive results in smaller observational studies, but these results were not duplicated in a large-scale, well-designed, randomized, controlled clinical trial. This discrepancy highlights the importance of large, randomized clinical trials; in fact, it is one of the central reasons that treatments should be subjected to rigorous trials before they are implemented into practice.

Randomized controlled trials are also critical to the medical field because they protect us from the very thing that often motivates us: the desire to cure. If there is no curative treatment for a condition, such as nonexudative AMD, clinicians are prone to lower the required level of evidence supporting a particular treatment because we so desperately want to help our patients. We want to eliminate their symptoms, improve their vision, and ease their minds; this powerful emotional drive can impair our ability to objectively evaluate the evidence.

The AREDS2 trial failed to prove what many patients and clinicians hoped that it would prove, but it should not be viewed as a "failure," because it produced high-quality clinical data. Identifying ineffective treatments is an integral part of the larger process of finding the most effective treatment. Although carotenoids and omega-3 fatty acids are not the long-awaited answer to delaying the progression of AMD, we are edging closer to a cure because we now know the true effects of these supplements.

Abstract

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