Toprol-XL Improves Survival In Heart Failure Patients

	March 8, 1999 - Adding Toprol-XL (metoprolol succinate extended release) to standard treatment in heart failure patients reduced the overall death rate by 34%, according to results of the Metoprolol CR/XL (Controlled Release) Randomized Intervention Trial in Heart Failure (MERIT-HF), the largest ever heart failure trial testing the effectiveness of a beta-blocker.
	The MERIT-HF study also found a 41% reduction in sudden deaths and a 49% reduction in heart failure deaths among patients treated with Toprol-XL. Results of MERIT-HF were announced at the American College of Cardiology (ACC) 48th annual scientific session.
	The MERIT-HF Study is the first trial of beta-blockers to include significant numbers of patients across a wide range of heart failure classes, ranging from those who experience slight symptoms to those unable to carry out any physical activity without discomfort. The study found that adding Toprol-XL benefited patients regardless of the severity of their disease. Response to the beta-blocker was similar for class 2,3 and 4 patients.
	In MERIT-HF, almost 4,000 patients in 14 countries with moderate to severe heart failure were given either once a day doses of placebo or Toprol-XL, titrating from 12.5mg or 25-200mg per day over 6 weeks. In the USA, more than 1,000 patients participated. The main aim of the study was to study the impact of extended release metoprolol compared with placebo on total mortality in CHF patients. Other results, such as hospitalisations, quality of life and health economics were also measured. Full analysis of this data is presently under way.
	MERIT-HF was started in February of 1997 and was expected to end in the year 2000. The study was stopped early in October of 1998, due to the significant reduction in mortality in Toprol-XL patients.
	Metoprolol CR/XL (marketed in the USA as Toprol-XL) is the most widely prescribed beta-blocker in the world. In the USA, it is approved only for high blood pressure and angina. Like most beta-blockers, Toprol-XL is contraindicated in sinus bradycardia, heart block greater than first degree, cardiogenic shock and acute heart failure. Patients with ischemic heart disease taking the medication should not stop taking it suddenly.
	"The search for a medication that can reduce mortality in CHF patients beyond standard therapy, is becoming more important as disease rate rises," said Stephen Gottlieb, MD, associate professor of medicine at the University of Maryland School of Medicine. "We are encouraged by the results of MERIT-HF because the significant 34% reduction in all-cause mortality adds to the growing evidence that beta-blockers are useful in heart failure."