Vericiguat for the treatment of heart failure: mechanism of action and pharmacological properties compared with other emerging therapeutic options
Introduction: The significant morbidity and mortality in patients with heart failure (HF), notably in the most advanced forms of the disease, justify the need for novel therapeutic options. In the last year, the soluble guanylate cyclase (sGC) stimulator, vericiguat, has drawn the attention of the medical community following the report of reduced clinical outcomes in patients with worsening chronic HF (WCHF).
Areas covered: The authors review Expert Option 模拟账户 the available data on the mechanism of action of vericiguat (cyclic guanosine monophosphate (cGMP) pathway), its clinical development program, its role in HF management, and its future positioning in the therapeutic recommendations.
Expert opinion: cGMP deficiency has deleterious effects on the heart and contributes to the progression of HF. Different molecules, including nitric oxide (NO) donors, phosphodiesterase inhibitors, and natriuretic peptides analogues, target the NO-sCG-cGMP pathway but have Expert Option 模拟账户 Expert Option 模拟账户 yielded conflicting results in HF patients. Vericiguat acts as a sGC stimulator thus targeting the Expert Option 模拟账户 NO-sGC-cGMP pathway by a different mechanism that complements the current pharmacotherapy for HF. Vericiguat has shown an additional statistical add-on therapy efficacy by reducing morbi-mortality in patients with Expert Option 模拟账户 WCHF. A better evaluation of HF severity might be an important determinant to guide the use of vericiguat among the available therapies.
Keywords: (5–8): cGMP pathway; heart failure (hf); heart failure hospitalization (hfh); heart failure with reduced ejection fraction (hfref); reduced left ventricular ejection fraction (lvef); sGC stimulator; soluble guanylate cyclase (sGC); ventricular remodeling; vericiguat; worsening chronic heart failure (wchf).
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Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee
In 2017, a National Rosacea Society Expert Committee developed and published an updated classification of rosacea to reflect current insights into rosacea pathogenesis, pathophysiology, and management. These developments suggest that a multivariate disease process underlies the various clinical manifestations of the disorder. The Expert Option 模拟账户 Expert Option 模拟账户 new system is consequently based on phenotypes that link to this process, providing clear Expert Option 模拟账户 parameters for research and diagnosis as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual. Meanwhile, a range of therapies has become available for rosacea, and their roles have been increasingly defined in clinical practice as the disorder has become more widely recognized. This update is intended to Expert Option 模拟账户 provide a comprehensive summary of management options, including expert evaluations, to serve as a Expert Option 模拟账户 guide for tailoring treatment and care on an individual basis to achieve optimal patient Expert Option 模拟账户 outcomes.
Keywords: drugs; erythema; flushing; lasers; lifestyle; management; ocular; papules; phenotypes; phymatous; Expert Option 模拟账户 Expert Option 模拟账户 pustules; rosacea; telangiectasia; therapy; utility.
Copyright © 2020 American Academy of Dermatology, Inc. Published by Expert Option 模拟账户 Elsevier Inc. All rights reserved.
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