Riociguat for chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension: a phase II study

We assessed the therapeutic potential of riociguat, a novel soluble guanylate cyclase stimulator, in adults with chronic thromboembolic pulmonary hypertension (CTEPH; n = 42) or pulmonary arterial hypertension (PAH; n = 33) in World Health Organization (WHO) functional class II/III. - In this 12-wee...

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Hauptverfasser: Ghofrani, Hossein Ardeschir (VerfasserIn) , Höper, Marius (VerfasserIn) , Halank, Michael (VerfasserIn) , Meyer, Franz Joachim (VerfasserIn) , Stähler, Gerd (VerfasserIn) , Behr, J. (VerfasserIn) , Ewert, Ralf (VerfasserIn) , Weimann, G. (VerfasserIn) , Grimminger, Friedrich (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: June 07 2010
In: The European respiratory journal
Year: 2010, Jahrgang: 36, Heft: 4, Pages: 792-799
ISSN:1399-3003
DOI:10.1183/09031936.00182909
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1183/09031936.00182909
Verlag, lizenzpflichtig, Volltext: https://erj.ersjournals.com/content/36/4/792
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Verfasserangaben:H.A. Ghofrani, M.M. Hoeper, M. Halank, F.J. Meyer, G. Staehler, J. Behr, R. Ewert, G. Weimann and F. Grimminger, on behalf of the study investigators

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520 |a We assessed the therapeutic potential of riociguat, a novel soluble guanylate cyclase stimulator, in adults with chronic thromboembolic pulmonary hypertension (CTEPH; n = 42) or pulmonary arterial hypertension (PAH; n = 33) in World Health Organization (WHO) functional class II/III. - In this 12-week, multicentre, open-label, uncontrolled phase II study, patients received oral riociguat 1.0-2.5 mg t.i.d. titrated according to systemic systolic blood pressure (SBP). Primary end-points were safety and tolerability; pharmacodynamic changes were secondary end-points. - Riociguat was generally well tolerated. Asymptomatic hypotension (SBP <90 mmHg) occurred in 11 patients, but blood pressure normalised without dose alteration in nine and after dose reduction in two. Median 6-min walking distance increased in patients with CTEPH (55.0 m from baseline (390 m); p<0.0001) and PAH (57.0 m from baseline (337 m); p<0.0001); patients in functional class II or III and bosentan pre-treated patients showed similar improvements. Pulmonary vascular resistance was significantly reduced by 215 dyn·s·cm−5 from baseline (709 dyn·s·cm−5; p<0.0001). 42 (56%) patients were considered to have experienced drug-related adverse events (AEs; 96% mild or moderate). Dyspepsia, headache and hypotension were the most frequent AEs. Study discontinuation because of AEs was 4%. - These preliminary data show that riociguat has a favourable safety profile and improves exercise capacity, symptoms and pulmonary haemodynamics in CTEPH and PAH. Randomised controlled trials are underway. 
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