Results from the longest and largest trial ever conducted in heart failure -- the Carvedilol or Metoprolol European Trial (COMET) showed that carvedilol, a newer, comprehensive beta-blocking medication reduced all cause mortality by 17 percent (p=0.0017), cardiovascular mortality by 20 percent (p=0.0004) and prolonged median survival by 1.4 years more than metoprolol tartrate, a traditional selective beta-blocking medication. Carvedilol is marketed as Coreg in the U.S. and Dilatrend in Europe.
"The results of COMET provide clear evidence of the survival benefits of carvedilol over metoprolol in the treatment of chronic heart failure and suggest that carvedilol prolongs the life of patients by 1.4 years compared to metoprolol," commented Professor Philip Poole-Wilson, Chairman of the COMET Steering Committee. "Carvedilol's significant survival benefit could mean thousands of lives saved each year."
The COMET investigators wanted to determine whether carvedilol, which has properties beyond those of traditional beta blockers, would reduce mortality and morbidity more than a beta-one selective blocker in patients with heart failure. They concluded that carvedilol has a significantly greater beneficial impact on survival than metoprolol.
"For years, physicians have wondered if there are important differences among beta blockers used for the treatment of heart failure," said Milton Packer, Director, Heart Failure Center and Professor of Medicine, Columbia University College of Physicians and Surgeons in New York, N.Y. "The results of the COMET study suggest that the additional properties of carvedilol beyond beta-one blockade do influence survival."
The results of the COMET study add even more weight to what is already a wealth of data demonstrating the important benefits of carvedilol. In the U.S., Coreg (carvedilol) is marketed by GlaxoSmithKline and is the only beta-blocking agent FDA approved to improve survival in mild to severe heart failure. Coreg is also approved for use in left ventricular dysfunction following a heart attack (with or without symptomatic heart failure) where it also significantly improves survival. Coreg also is indicated for the treatment of essential hypertension. In Europe, Dilatrend (carvedilol) is marketed by Roche and is approved for congestive heart failure, angina pectoris and hypertension.
In Europe, metoprolol tartrate, which was used in the COMET study, is approved for indications that include the following: hypertension, angina pectoris, arrhythmias, myocardial infarction, migraine, hyperthyroidism, and is marketed by AstraZeneca as Betaloc and by Novartis as Lopresor.