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Centrum Silver© Prevention Study

Darrell Hulisz, RPh, PharmD
Kelly Fargo

December 3, 2012

The Physicians' Health Study was a randomized, placebo controlled, double blind trial published in the Journal of the American Medical Association (JAMA) in November 2012. 1,2 In total, 14,641 male physicians 50 years and older were randomized to a daily multivitamin (Centrum Silver®), or placebo. Broadly, the objective of the trial was to define the benefits of extended use of multivitamins, in terms of the development of total and/or site specific cancer, as well as cardiovascular disease events and mortality. The median follow-up period was 11.2 years.

This trial examined cancer development as well as morbidity and mortality outcomes. The authors conclude that there was a statistically significant reduction in total primary cancer reduction. However, cardiovascular morbidity and mortality outcomes were found to be non-significant.

There are several elements of this trial that must be critically examined beginning with limiting inclusion to male physicians. This severely compromises generalizability to males with excellent access to healthcare. Additionally, those randomized to the intervention group were given a Men's Centrum® Silver® multivitamin as well as 400 international units (IU) vitamin E every other day, vitamin C 500 mg daily and beta carotene 50 mg every other day. This significantly confounds the results. The data is additionally confounded by the inclusion of those with baseline cancer at randomization.

In conclusion, a decision to recommend a multivitamin for the prevention of cancer should tempered by the significant limitations of this study. If a multivitamin is recommended for cancer prevention the benefit will be driven based on quality of life and economic concerns due to the non-significant decrease in mortality reported.

1. Gaziano JM et al. Multivitamins in the Prevention of Cancer in Men: The Physicians' Health Study II Randomized Controlled Trial. JAMA. 2012: 308(18); E1-E10.

2. Sesso HD et al. Multivitamins in the Prevention of Cardiovascular Disease in Men. The Physicians' Health Study II Randomized Controlled Trial. JAMA. 2012; 308 (17); 1751-1760.

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