Prescribing Advice for GPs

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AMD not prevented by antioxidant supplements

The British Medical Journal has published the results of a meta analysis that aimed to evaluate the effectiveness of dietary antioxidants in the primary prevention of age related macular degeneration (AMD).

Two reviewers independently searched for relevant papers using standardised search criteria and identified 4,192 abstracts. Nine cohort studies (involving 149,203 people) and three randomised controlled trials met the inclusion criteria for further analysis.

Different antioxidants were analysed separately, not all studies contributed to each analysis. Data from the cohort studies found that vitamin A, vitamin C, vitamin E, zinc, lutein, zeaxanthin, alpha carotene, beta carotene, beta cryptoxanthin and lycopene had little or no effect in prevention of early AMD. The randomised controlled trials also failed to show any benefit from antioxidant supplements in the prevention of early AMD.

The authors of the paper conclude that there is "insufficient evidence to support the role of dietary antioxidants, including the use of dietary antioxidant supplements, for the primary prevention of early AMD".

Action: Clinicians should ensure that antioxidant supplements are not prescribed at NHS expense for the primary prevention of AMD.

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