Riociguat for the treatment of chronic thromboembolic pulmonary hypertension.

@article{Ghofrani2013RiociguatFT,
  title={Riociguat for the treatment of chronic thromboembolic pulmonary hypertension.},
  author={Hossein Ardeschir Ghofrani and Andrea Maria D'armini and Friedrich Grimminger and Marius M. Hoeper and Pavel Jansa and Nick H S Kim and Eckhard Mayer and G{\'e}rald Simonneau and Martin R. Wilkins and Arno Fritsch and Dieter Neuser and Gerrit Weimann and Chen Wang},
  journal={The New England journal of medicine},
  year={2013},
  volume={369 4},
  pages={
          319-29
        }
}
BACKGROUND Riociguat, a member of a new class of compounds (soluble guanylate cyclase stimulators), has been shown in previous clinical studies to be beneficial in the treatment of chronic thromboembolic pulmonary hypertension. METHODS In this phase 3, multicenter, randomized, double-blind, placebo-controlled study, we randomly assigned 261 patients with inoperable chronic thromboembolic pulmonary hypertension or persistent or recurrent pulmonary hypertension after pulmonary endarterectomy to… 
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Riociguat for the treatment of pulmonary arterial hypertension.
TLDR
Riociguat significantly improved exercise capacity and secondary efficacy end points in patients with pulmonary arterial hypertension and showed significant improvements in pulmonary vascular resistance, NT-proBNP levels, World Health Organization functional class, and time to clinical worsening.
The safety and effectiveness of riociguat to treat chronic thromboembolic pulmonary hypertension
TLDR
Riociguat, an oral soluble guanylate cyclase (sGC) stimulator is the first pharmacotherapeutic agent that has been shown to improve exercise capacity and hemodynamics in a large multicenter, double-blind, randomized placebo-controlled trial for the treatment of patients with inoperable or persistent CTEPH.
The safety and effectiveness of riociguat to treat chronic thromboembolic pulmonary
TLDR
Riociguat, an oral soluble guanylate cyclase (sGC) stimulator is the first pharmacotherapeutic agent that has been shown to improve exercise capacity and hemodynamics in a large multicenter, double-blind, randomized placebo-controlled trial for the treatment of patients with inoperable or persistent CTEPH.
Riociguat for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.
  • Bryan Bishop
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2014
TLDR
Riociguat is a soluble guanylate cyclase stimulator approved for the treatment of CTEPH and PAH and should be considered as an alternative to phosphodiesterase type-5 inhibitors in patients with PAH.
Riociguat: A Novel New Drug for Treatment of Pulmonary Hypertension
TLDR
Riociguat was tolerated at maximal doses by most patients during PATENT‐1 and CHEST‐ 1 and was well tolerated during long‐term extension studies.
Riociguat: Clinical research and evolving role in therapy
TLDR
Riociguat has antifibrotic, antiproliferative and anti‐inflammatory effects, in addition to vasodilatory properties, which has led to further clinical studies in patients who do not achieve a satisfactory clinical response with phosphodiesterase type‐5 inhibitors.
Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: a long-term extension study (CHEST-2)
TLDR
Long-term riociguat had a favourable benefit–risk profile and apparently showed sustained benefits in exercise and functional capacity for up to 1 year in CHEST-2.
Riociguat: A Review of Its Use in Patients with Chronic Thromboembolic Pulmonary Hypertension or Pulmonary Arterial Hypertension
TLDR
Riociguat is effective and well tolerated in patients with inoperableCTEPH or persistent/recurrent CTEPH following pulmonary endarterectomy, and in patientsWith PAH, it has a positive result on exercise capacity and pulmonary haemodynamics, and improves WHO functional class.
Riociguat for patients with chronic thromboembolic pulmonary hypertension: Usefulness of transitioning from phosphodiesterase type 5 inhibitor.
Riociguat for the treatment of pulmonary arterial hypertension: a long-term extension study (PATENT-2)
TLDR
Long-term riociguat was well tolerated in patients with pulmonary arterial hypertension, and led to sustained improvements in exercise capacity and functional capacity for up to 1 year.
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References

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TLDR
Preliminary data show that riociguat has a favourable safety profile and improves exercise capacity, symptoms and pulmonary haemodynamics in CTEPH and PAH.
Long-term use of sildenafil in inoperable chronic thromboembolic pulmonary hypertension.
TLDR
Although this pilot study was insufficiently powered to test the primary end point, it did suggest beneficial effects in favor of sildenafil in several secondary end points at both 3 months and 12 months.
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TLDR
Riociguat significantly improved pulmonary haemodynamic parameters and cardiac index in patients with PH in a dose-dependent manner, to a greater extent than inhaled NO, and has potential as a novel therapy for pulmonary hypertension.
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TLDR
Despite the improvement in medical treatment of inoperable CTEPH, the mortality rate is still high, and clinical worsening occurred in a substantial number of patients during a follow-up of more than 3 years.
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TLDR
The IV administration of prostacyclin caused beneficial hemodynamic effects in patients with severe CTEPH and may serve as pretreatment for patients undergoing pulmonary thromboendarterectomy.
Riociguat for the treatment of pulmonary hypertension
TLDR
This review will help readers understand the mechanism of action of the soluble guanylate cyclase (sGC) stimulator riociguat (BAY 63-2521) and will provide a comprehensive summary regarding efficacy and safety of this drug in the management of PH.
Clinical worsening after pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension
TLDR
Pulmonary endarterectomy is associated with good long-term survival and freedom from clinical worsening in patients with CTEPH, however, clinical worsening occurred in a substantial number of patients at long- term follow-up.
Predictors of Outcome in Chronic Thromboembolic Pulmonary Hypertension
TLDR
CTEPH-predisposing medical conditions, such as splenectomy, permanent central intravenous lines, and certain inflammatory disorders, predict poor survival in CTEPH.
Long-term outcome with first-line bosentan therapy in idiopathic pulmonary arterial hypertension.
TLDR
In this series of consecutive IPAH patients treated with bosentan, improvements in exercise capacity and haemodynamics were similar to those observed in previous randomized trials, however, on the basis of local criteria, many patients required the addition of prostanoid therapy during follow-up.
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