Vericiguat ineffective for patients with worsening HFpEF
Vericiguat treatment does not appear to improve the physical limitations of patients who present with worsening heart failure with preserved ejection fraction (HFpEF), according to new findings published in JAMA.
“HFpEF is associated with substantial morbidity and mortality,” wrote lead author Paul W. Armstrong, MD, a cardiologist at the University of Alberta in Edmonton, Canada, and colleagues. “Apart from relieving congestion with diuretics and modifying concomitant comorbidities, the absence of definitive therapy is especially problematic. The lack of therapies to address the impairment in functional capacity and quality of life imposed by HFpEF remains a major unmet need for patients and presents a significant clinical challenge.”
Previous research had suggested that vericiguat may help patients with worsening HFpEF by improving their ability to perform certain physical activities as measured by the physical limitations section of the Kansas City Cardiomyopathy Questionnaire (KCCQ). To explore that possibility, Armstrong et al. carried out a randomized clinical trial of nearly 800 patients with a history of chronic HF.
All patients participating in the team’s research had either been hospitalized for HF or received an intravenous diuretic treatment for HF within six months of the start of the study. They were each randomly chosen to receive a treatment of 10 mg/d of vericiguat, 15 mg/d of vericiguat or a placebo.
Overall, the research team reported, vericiguat was not linked to any significant improvements in the cohort’s KCCQ physical limitation scores after 24 weeks of treatment.
“Enrolling a less ill population with stable quality-of-life measures established over months might have yielded a different result,” the authors concluded. “However, these findings … may also reflect that nitric oxide is not a key operative factor in the progression of HFpEF; indeed, lack of benefit with oral nitrates, inhaled nitrites and phosphodiesterase inhibitors suggests that direct soluble guanylate cyclase stimulation with vericiguat was ineffective.”
Some authors, including Armstrong, reported receiving personal fees from Merck and Bayer, the manufacturers behind vericiguat.
Read the full study here.