September 2013 pulmonary journal club: riociguat; pay the doctor

• Main Author: Robbins RA
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2013-09-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: riociguat; pulmonary hypertension; thromboembolic pulmonary hypertension; left ventricular dysfunction; guanylate cyclase; pay for performance; affordable care act; Obamacare; Veterans Administration; outcomes; ACA; treatment
• Online Access: http://www.swjpcc.com/pulmonary-journal-club/2013/9/16/september-2013-pulmonary-journal-club-riociguat-pay-the-doct.html

No abstract available. Article truncated at 150 words. Three articles appeared within the past month describing clinical trials with riociguat, a new therapy for pulmonary arterial hypertension (PAH). Riociguat is a soluble guanylate cyclase stimulator. Guanylate cyclase is the enzyme that is stimulated by nitric oxide which results in arterial smooth muscle relaxation. All three trials were phase 3, multicenter, randomized, placebo-controlled studies sponsored by Bayer, the manufacturer. In the first trial, 261 patients with inoperable chronic thromboembolic pulmonary hypertension or persistent or recurrent pulmonary hypertension after pulmonary endarterectomy were randomized to receive placebo or riociguat. The primary end point was the change from baseline to the end of week 16 in the distance walked in 6 minutes. Secondary end points included changes from baseline in pulmonary vascular resistance, N-terminal pro-brain natriuretic peptide (NT-proBNP) level, World Health Organization (WHO) functional class, time to clinical worsening, Borg dyspnea score, quality-of-life variables, and safety. By week 16, the 6-minute walk …