This article is more than 5 years old. Information may no longer be current.
Genetic markers predict response to antioxidants and zinc in patients with AMD
Click Here to Manage Email Alerts
TORONTO — Genotype-directed nutritional therapy could double the reduction in rate of progression to advanced age-related macular degeneration compared with therapy with the AREDS formulation, a speaker said here.
In a genetic analysis of 995 AREDS patients grouped by AREDS category, Carl C. Awh, MD, and colleagues concluded that genetic risk markers CFH and ARMS2 can predict response to antioxidants and zinc in patients with moderate AMD.
Carl C. Awh
“For example, CFH binds zinc,” Awh told colleagues at the American Society of Retina Specialists meeting. “This neutralizes its ability to inhibit C3.”
For placebo treated patients, both CFH and ARMS2 had a statistically significant impact on progression rate; for patients given antioxidants, only ARMS2 had such an impact, Awh said.
“The ARMS2 protein has been localized to mitochondria, where there may be a potential interaction or effect on the interaction of antioxidants with free radicals,” he said. For patients taking both zinc and antioxidants, both CFH and ARMS2 had a statistically significant impact on rate of progression.
There is sometimes a dramatic difference in rate of progression among the different genotypes receiving the same treatment, according to Awh.
“For many, there is an obvious best and worst treatment,” Awh said. For example, patients with C2A0 genotype who take zinc do worse and other patients with the same genotype who take antioxidants do best.
“The optimal treatment regimen for 49% of study patients is something other than the AREDS formulation,” Awh said.
In calculating 10-year progression rates to advanced AMD, Awh said that genotype-directed therapy would result in a 33% reduction in rate of progression versus a 14% reduction in rate of progression in patients taking the AREDS formulation.
“Genotype directed therapy more than doubles the reduction in AMD progression compared to treatment with the AREDS formulation,” Awh said.
Disclosure: Awh is a consultant to and an investor in ArcticDx and has intellectual property interest in some of the material presented.