Starting treatment of heart failure with Merck KGaA’s selective beta-blocker Cardicor (bisoprolol) is at least as effective and well tolerated as starting with an ACE inhibitor, according to results of the CIBIS III trial, presented at the European Society of Cardiology meeting in Stockholm on 4 September. Furthermore, a Cardicor-first strategy may reduce sudden death in the first year of treatment when this risk is particularly high.

Previous studies have shown that heart-failure patients benefit from treatment with a beta-blocker, but current national and international heart failure guidelines have - for some time - recommended that doctors should start treatment with an ACE inhibitor, followed by a beta blocker. Although some doctors may be slow to change their long-standing practice, CIBIS III is the first study to compare a beta blocker and an ACE inhibitor as initial treatments for heart failure, and the result is undoubtedly good news for Merck as it will give Cardicor a real competitive advantage over other beta-blockers.

In short, CIBIS III gives Merck has a great opportunity to increase its share of the huge heart-failure market. At present about 14 million people in Europe suffer from this severe, progressive condition, but the ageing population means that this number is expected to increase to 30 million by 2020.

By Sue Lyon in Stockholm.