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MERCK RESPONDS TO CAPTOPRIL VS. VASOTEC QUALITY OF LIFE STUDY

 WEST POINT, N.J., April 1 /PRNewswire/ -- Merck & Co., Inc. (NYSE: MRK) today said that the results of previous studies involving thousands of patients on the ACE inhibitor Vasotec(R) (enalapril maleate) do not support the findings of yesterday's New England Journal of Medicine study which concluded that the "quality of life" for patients on captopril was improved more than those on Vasotec.
 "The results of the captopril study fly in the face of the widespread clinical use of Vasotec. More than two million patients in the U.S. are using Vasotec for hypertension and we have not received reports indicating a negative effect on quality of life," according to Dr. Louis Sherwood, senior vice president of medical and scientific affairs, Merck U.S. Human Health Division. Quality of life studies are emerging as increasingly important in the medical community. Since 1980, there have been more than 200 published reports addressing quality of life and antihypertensive agents. Many of these evaluate ACE inhibitors, including Vasotec. All previous studies show either positive or neutral effects with Vasotec and include:
 -- A large randomized study comparing the effect of Vasotec,
 captopril, atenolol and propranolol on efficacy and quality
 of life in 360 males showed that Vasotec, captopril and
 atenolol generally had equivalent effects on quality of
 life, while propranolol showed significantly less
 improvement. Importantly, both Vasotec and atenolol were
 associated with improvement in both life and social
 satisfaction.
 -- A large multicenter study with 3,000 patients on Vasotec
 demonstrated improvements in energy level, emotional
 reactions, sleep and social interactions as well as
 improvements in activities of daily living at home and at
 work during therapy with Vasotec.
 There are significant differences in the methodology; the validity of these studies remains a subject of discussion, and a medical consensus has yet to emerge on what constitutes an adequate and well- controlled quality of life study.
 Regarding the Bristol-Myers Squibb-sponsored study, Dr. Sherwood said some of the methodology used is not generally accepted by the medical community. Further, only one out of six scales used to measure change in quality of life appeared to have differences that were statistically significant in favor of captopril. None of the other scales demonstrated a statistically significant difference between groups. "The one clear conclusion that can be drawn from the study was that Vasotec is an effective, well-tolerated and convenient treatment for hypertension," Sherwood said.
 Vasotec is indicated for the treatment of hypertension and symptomatic congestive heart failure.
 Merck is a worldwide, research intensive pharmaceutical company that discovers, develops, produces and markets human and animal health products and specialty chemicals. In 1992, the company spent in excess of $1.1 billion on research and development.
 Note: Complete prescribing information for Vasotec is available from Merck.
 /delval/
 -0- 4/1/93
 /CONTACT: Gary M. Bruell of Merck, 215-652-7485/
 (MRK)


CO: Merck & Co., Inc. ST: New Jersey IN: MTC SU:

CC -- PH040 -- 2268 04/01/93 17:24 EST
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Date:Apr 1, 1993
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