ANMCO position paper on vericiguat use in heart failure: from evidence to place in therapy

Abstract

In the growing therapeutic armamentarium for heart failure (HF) management, vericiguat represents an innovative therapeutic option. The biological target of this drug is different from that of other drugs for HF. Indeed, vericiguat does not inhibit neuro-hormonal systems overactivated in HF or sodium–glucose co-transporter 2 but stimulates the biological pathway of nitric oxide and cyclic guanosine monophosphate, which is impaired in patients with HF. Vericiguat has recently been approved by international and national regulatory authorities for the treatment of patients with HF and reduced ejection fraction who are symptomatic despite optimal medical therapy and have worsening HF. This ANMCO position paper summarises key aspects of vericiguat mechanism of action and provides a review of available clinical evidence. Furthermore, this document reports use indications based on international guideline recommendations and local regulatory authority approval at the time of writing.

The sGCa Vericiguat Exhibit Cardioprotective and Anti-Sarcopenic Effects through NLRP-3 Pathways: Potential Benefits for Anthracycline-Treated Cancer Patients

“…Vericiguat exerts a cardioprotective effect by targeting the guanylate cyclase enzyme, which plays a role in regulating the synthesis of cyclic guanosine monophosphate (called cGMP), a molecule involved in the relaxation and dilation of blood vessels [23,24]. By stimulating soluble guanylate cyclase, vericiguat increases the production of cGMP, leading to vasodilation and reduced myocardial strain [25]. Moreover, it also improved heart function, decreasing fibrosis and promoting diuresis [26].…”