Riociguat (Adempas)

Indications

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) (see Chronic Thromboembolic Pulmonary Hypertension)

  • CHEST-1 Study of Riociguat in Patients with Inoperable CTEPH/Persistent or Recurrent CTEPH After Pulmonary Thrombendarterectomy (PTE) Surgery (2013) [MEDLINE]
    • Riociguat Improved Exercise Capacity (6-Minute Walk Test)
    • Riociguat Improved Pulmonary Vascular Resistance (PVR)
    • Riociguat Decreased NT Pro-BNP Levels
    • Riociguat Improved WHO Functional Class
  • Use of Riociguat as a Bridge to PTE Surgery Has Not Been Studied

Pulmonary Hypertension (see Pulmonary Hypertension)

  • PATENT-1 Study of Riociguat in Symptomatic Pulmonary Hypertension (2013) [MEDLINE]
    • Riociguat Improved Exercise Capacity (6-Minute Walk Test)
    • Riociguat Improved Pulmonary Vascular Resistance (PVR)
    • Riociguat Decreased NT Pro-BNP Levels
    • Riociguat Improved WHO Functional Class
    • Riociguat Improved Time to Clinical Worsening
    • Riociguat Improved Borg Dyspnea Score

Pharmacology

  • Pulmonary Vasodilator
    • Directly Stimulates Soluble Guanylate Cyclase (sGC)
    • Sensitizes sGC to NO

Metabolism

  • xxx

Administration

  • PO

Dose Adjustment

  • Hepatic
  • Renal

Adverse Effects

Cardiovascular Adverse Effects

  • Right Ventricular Failure (see xxxx, [[xxxx]]): although occurred in the same percentage of patients (3%) in both placebo and riociguat groups [MEDLINE]
  • Syncope (see Syncope, [[Syncope]]): occurred in 2% of riociguat group vs 3% of placebo group [MEDLINE]

Neurologic Adverse Effects

Other

  • xxx
  • xxx
  • xxx
  • xxx

References

  • Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2009;30:2493-2537 [MEDLINE]
  • Riociguat for chronic thomboembolic pulmonary hypertension and pulmonary arterial hypertension: a phase II study. Eur Respir J 2010;36:792-799 [MEDLINE]
  • CHEST-1 Study Group. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013 Jul 25;369(4):319-29. doi: 10.1056/NEJMoa1209657 [MEDLINE]
  • PATENT-1 Study Group. Riociguat for the treatment of pulmonary arterial hypertension. N Engl J Med. 2013 Jul 25;369(4):330-40. doi: 10.1056/NEJMoa1209655 [MEDLINE]
  • Riociguat for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Am J Health Syst Pharm. 2014 Nov 1;71(21):1839-44. doi: 10.2146/ajhp130777 [MEDLINE]