Pulmonary Arterial Hypertension in Adults: Novel Drugs and Catheter Ablation Techniques Show Promise? Systematic Review on Pharmacotherapy and Interventional Strategies

Table 4

Patients, etiology, end points, treatment effects, and adverse reactions of the US Food and Drug Administration approved soluble guanylate cyclase stimulators in the pivotal Phase III randomized controlled trials for treatment of pulmonary arterial hypertension in adults.

	PATENT-1 [34]	CHEST-1 [35]
Patients (no.)	443	261
Drug	RIOCIGUAT
Dosing/route	0.5–2.5 mg tid/os
Follow-up (months)	3	4
Etiology (%)*
IPAH	63	—
CTD	25	—
CHD	8	—
Portopulmonary	3	—
Anorexigen use	1	—
CTEPH
Inoperable	—	70
Postoperative	—	30
Functional class
NYHA/WHO I	3	2
NYHA/WHO II	40	32
NYHA/WHO III	56	62
NYHA/WHO IV	1	5
Primary end point	6MWD	6MWD
Treatment effects
Δ6MWD (m)	30	39
Hemodynamics	Improved	Improved
Clinical worsening	Reduced	No change
Adverse reactions	Headache, peripheral edema, hypotension, dizziness, and syncope

PATENT: Pulmonary Arterial hyperTENsion Soluble Guanylate-Cyclase-Stimulator Trial; CHEST: CHronic thromboEmbolic Pulmonary Hypertension Soluble Guanylate-Cyclase-Stimulator Trial; tid: three times daily; os: oral; ∗sum of percentage may not be 100% for rounding to the nearest unit; 0.5 is rounded to the upper unit; IPAH: idiopathic pulmonary arterial hypertension; CTD: connective tissue disease; CHD: congenital heart disease (congenital systemic-to-pulmonary shunts); CTPEH: chronic thromboembolic pulmonary hypertension; NYHA: New York Heart Association; WHO: World Health Organization; 6MWD: 6 min walk distance; Δ: mean (or median) change from baseline.