Description of the goods or services required
The Health Technology Assessment Programme is accepting stage 1 applications to their commissioned workstream for this primary research topic:
19/36 Antioxidant supplements to slow AMD progression
Age-related macular degeneration (AMD) is the most common form of macular degeneration and
the most common cause of visual impairment in the developed world. Incidence and severity
increase with advancing age and with an aging population AMD is a significant concern now and
for the future.
Treatments exist for the most severe forms of the disease but these are invasive and expensive so
preventing or slowing progression of the disease before it gets to this stage is a priority. Lifestyle
and nutrition have been linked to development and progression of AMD but to date no way of
preventing these has been identified.
There is some evidence that antioxidant vitamin and mineral supplements might slow progression
of early AMD in people at high risk of developing advanced disease but the quality of the evidence
is variable. The AREDS (Age-Related Eye Disease Study) and AREDS2 trials from the US
dominate the literature and some authors and guidelines advise that the evidence from these is
sufficient to recommend use of the AREDS2 supplement formula for slowing progression of AMD.
However, NICE has recently concluded that limitations in the available evidence, including in the
AREDS and AREDS2 studies, means no firm conclusions can be drawn on whether such
antioxidant/vitamin supplements confer significant benefit (and without increasing risks) to patients
with AMD. As such, NICE has called for an adequately powered, good quality randomised
controlled trial to resolve the uncertainty that remains about the use of antioxidant/vitamin
supplements in this population. Applicants will need to take account of baseline diet/nutritional
status and food intake and if and how this can be recorded or measured throughout the period of