Vascular Health and Risk Management (Oct 2022)
Evaluating Riociguat in the Treatment of Pulmonary Arterial Hypertension: A Real-World Perspective
Abstract
Andrew D Mihalek,1 Christopher D Scott,2 Sula Mazimba3 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA; 2Division of Thoracic Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, USA; 3Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USACorrespondence: Andrew D Mihalek, University of Virginia Division of Pulmonary and Critical Care Medicine, 1215 Lee Street, Charlottesville, VA, 22903, Tel +1 (434) 243-1000, Fax +1 (434) 924-9720, Email [email protected]: Pulmonary hypertension (PH) is a broad term describing the mean pulmonary artery pressure, as measured by right heart catheterization, exceeds 20mmHg. Pulmonary arterial hypertension (PAH) exists when PH is accompanied by a normal wedge pressure and elevated pulmonary vascular resistance. PAH is typified by dysmorphic and dysfunctional pulmonary arterial vasculature. Attempting to restore the functionality of the pulmonary artery is a hallmark of care to the PAH patient. Riociguat is a powerful stimulator of soluble guanylate cyclase and increases blood flow through the pulmonary arteries by dilating vascular smooth muscle cells. This review examines the pharmacology of riociguat, the fundamental clinical trials applying it to PAH patients, practical aspects when selecting its use, and future directions for its utilization.Keywords: pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, riociguat, soluble guanylate cyclase stimulator
