Vericiguat is a medicinal product in clinical development for the treatment of heart failure (HF) with reduced ejection fraction. HF is a complex clinical syndrome of symptoms and signs that suggest the efficiency of the heart as a pump is impaired. Symptoms include breathlessness and fatigue, and signs of the condition include swollen ankles and crackling sounds in the lungs. More than half of people with HF have a reduced ejection fraction (HFrEF), also referred to as systolic heart failure, where the heart muscle does not contract effectively, and therefore less oxygen-rich blood is pumped out to the body. There remains a large unmet need for new therapies in the treatment of HFrEF.
Vericiguat is given by mouth (tablets) and works by stimulating a protein called soluble guanylate cyclase (sGC). In people without HF, sGC is naturally stimulated by a chemical called nitric oxide (NO) present within the blood vessels. The stimulation of sGC is required for normal heart function. Patients with HF produce less NO, meaning they are unable to naturally stimulate sGC which leads to symptoms of HF. Therefore, stimulation of sGC by vericiguat helps to relieve symptoms of HF. If licensed, vericiguat may provide a treatment option for people with HFrEF who currently have limited therapies available.
Treprostinil is in clinical development for patients with chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a progressive disease caused by blood clots forming in the lungs that do not dissolve. These clots restrict blood flow through the lungs and cause scar tissue to form on the inside of the pulmonary arteries (arteries that supply the lungs) resulting in pulmonary hypertension. This means the heart has to work harder to pump the blood and can weaken the heart muscles. Some patients may be offered surgery to remove the scar tissue but in patients who are inoperable or who have persistent/recurrent CTEPH after surgery there is a need for additional treatment options.