A review of supplements available – both online and in-store for patients with age-related macular degeneration (AMD) – has highlighted variable pricing and resemblance to the recommended AREDS 2 formulation.
Based on promising outcomes for decelerating the progression of AMD to an advanced stage, many pharmaceutical companies have incorporated the AREDS 2 recipe into eye supplement formulations.
The supplements are recommended to patients with intermediate stage AMD because it can be difficult for them to consume a quantity of vitamins and minerals, equivalent to the AREDS 2 formulation, on a daily basis.
However, as there is no prescription required, patients are left to self-select products that are available in pharmacy or online.
Authors Dr Ben La Hood, Dr Ye Li and Dr Nick Andrew hope their study, which has been published in Clinical and Experimental Optometry will help clinicians when counselling patients on the benefits and suitability of supplements.
With patients commonly querying whether consuming a supplement will be helpful for their AMD, he said a table categorising products, and included in the published review, will support eye health clinicians during discussions.
A COMPREHENSIVE REVIEW
The authors initially reviewed 66 products available in Australia, the United States, the United Kingdom, and Canada. Of these, 43 products which contained all the AREDS 2 ingredients were included for analysis. Out of these 43 products, they found 20 contained all ingredients at 100% or more of the recommended dose, and 23 contained some ingredients at a lower dose.
They reported different forms in which the product is presented (tablet, capsule, soft-gel, and powder to make up as a drink), and the different dosing according to product, noting that “supplements with more than once-daily dosing could impose difficulties on those with poor compliance and poor ability to selfadminister medication”.
The authors noted that the efficacy of commercially available AMD supplements is likely to be variable due to the lack of standardisation of the type and dose of ingredients present, especially as the efficacy of individual products has not been evaluated or compared in the literature.
There were also variations in cost, ranging from AU$0.12 to $6.72 per day, prompting the authors to write, “Cost is certainly an important factor to consider, as these supplements are not routinely subsidised through pharmaceutical funding schemes. Clinicians should consider the ability of patients to afford these supplements, and the decision-making process should involve a discussion about their disease severity, average diet, financial circumstances, as well as age and life expectancy. This is of significance at an upstream level, as AMD may be more prevalent in those of a lower socioeconomic background, which is associated with a higher incidence of smoking.”
Across all countries reviewed, seven (35%) products were only available online and 13 (65%) products were available both online and in pharmacies. Only one of the products was available in Australian pharmacies, in contrast with other countries where pharmacies offered multiple options (eight in the United States pharmacies, five in Canadian pharmacies, and three in the United Kingdom).
The study is available at www.tandfonline.com/doi/abs/10.1080/08164622.2021.1989264?journalCode=tceo20