A new mechanism for the treatment of heart failure with Vericiguat!

Vericiguat can regulate endothelial function and myocardial energy metabolism through the nitric oxide cyclic guanosine monophosphate signaling pathway (NO-sGC-cGMP). It is a soluble guanylate cyclase (sGC) agonist and can improve the prognosis of HF patients. It increases intracellular cGMP levels, leading to smooth muscle relaxation and vasodilation.

Veliciguat was approved by the U.S. Food and Drug Administration (FDA) on January 20, 2021, for the treatment of chronic heart failure with reduced ejection fraction (HFrEF). On July 22, 2021, the European Union approved the marketing of Veciguat. Veciguat can treat heart failure from the root of the problem. Vericiguat can catalyze the synthesis of intracellular cyclic guanosine monophosphate (cGMP) by directly stimulating sGC, independent of NO and synergistic with NO. It is the first drug to be used to treat patients with exacerbation of chronic heart failure.

The VICTORIA study is a placebo-controlled phase III clinical study that randomly enrolled 5,050 patients aged ≥18 years with chronic heart failure who had New York Heart Association functional class II, III or IV and an ejection fraction less than 45% to receive either vericiguat or placebo. The results of the study showed that compared with the placebo group, the primary endpoint of the vericiguat group was reduced by 10%; the heart failure hospitalization rate was 27.4% for vericiguat and 29.6% for placebo, and the incidence of cardiovascular death was 16.4% for vericiguat. , the placebo group was 17.5%. In terms of the composite endpoint incidence of death or heart failure hospitalization, the vericiguat group was 37.9% and the placebo group was 40.9%. The vericiguat group was lower than the placebo group. In addition, the safety analysis of this study showed that vericiguat was well tolerated and had a low incidence of adverse reactions. The most common adverse reactions are hypotension and anemia.

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