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Last Updated: April 28, 2025

CLINICAL TRIALS PROFILE FOR ADEMPAS


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All Clinical Trials for ADEMPAS

Trial IDTitleStatusSponsorPhaseStart DateSummary
NCT02633397 ↗ A Multi-Center Study of Riociguat in Patients With Sickle Cell Diseases Recruiting Gregory J. Kato, MD Phase 2 2017-04-11 The proposed study is a Phase 2 multi-center, randomized, double-blind, placebo-controlled, parallel groups study aimed to evaluate the safety, tolerability and the efficacy of riociguat compared with placebo in patients with sickle cell disease (SCD).
NCT02545465 ↗ A Study to Understand the Treatment Patterns in Patients With Pulmonary Arterial Hypertension or Chronic Thromboembolic Pulmonary Hypertension During a Switch of Treatment to Adempas in Real-life Clinical Practice Completed Bayer 2015-09-15 The aim of this study is to understand the treatment patterns in patients with Pulmonary Arterial Hypertension (PAH) or Chronic Thromboembolic Pulmonary Hypertension (CTEPH) during a switch of treatment to Adempas in real-life clinical practice. In addition, this study will describe patient demographics and reason for switching
NCT02159326 ↗ Microgynon Riociguat Drug Interaction Study in Healthy Postmenopausal Women Completed Bayer Phase 1 2014-06-01 Physicians might be concerned that Adempas may have a metabolic interaction with oral contraceptives (OC) that could decrease the contraceptive efficacy of the OC. The information regarding lack of potential pharmacokinetic interaction has been communicated; there is a need for more re-assurance and further data that there is no interaction between Adempas and OCs. A drug-drug interaction study of riociguat with an OC such as Microgynon in the least vulnerable population for these purposes, i.e. healthy postmenopausal women, is considered adequate to inform about safe use of Adempas with OCs.
NCT02092818 ↗ EXPERT, EXPosurE Registry RiociguaT in Patients With Pulmonary Hypertension Completed Bayer 2014-05-31 In accordance with the regulatory guidance this registry has been designed to collect information about the long-term safety of Adempas in real clinical practice outside the regulated environment of a controlled clinical study.
NCT02024386 ↗ Efficacy Study of Riociguat and Its Effects on Exercise Performance and Pulmonary Artery Pressure at High Altitude Completed Richard Moon Phase 4 2014-01-01 During ascent to high altitude there is a physiologic response to hypoxia that results in an elevated pulmonary arterial pressure associated with decreased exercise performance, altitude-induced pulmonary hypertension, and high altitude pulmonary edema (HAPE). Riociguat is a novel agent from Bayer Pharmaceuticals that has already demonstrated effectiveness in the treatment of pulmonary hypertension, and it may prove to be beneficial in cases of altitude-induced pulmonary hypertension or HAPE. This research study, composed of 20 healthy volunteers ages 18-40 years, will attempt to mimic the decreased oxygen supply and elevated pulmonary artery pressures found in conditions of high altitude, allowing observation of the effects of riociguat and exercise on pulmonary arterial pressure, arterial oxygenation, and exercise performance. Prior to entering the hypobaric chamber, subjects will have radial arterial lines and pulmonary artery catheters placed to obtain arterial and pulmonary artery pressure measurements. Subjects will then enter the hypobaric chamber and perform exercise tolerance tests at a simulated altitude of 15,000 feet on an electrically braked ergometer (exercise bike) before and after administration of riociguat. If, after administration of riociguat and exposure to a simulated altitude of 15,000 feet, the exercise performance is improved and observed pulmonary artery pressures are lower than those measurements seen prior to administration of riociguat, this could lead to development of a prophylactic and/or treatment strategy for HAPE and high-altitude pulmonary hypertension. Statistical analysis will compare the variables of pulmonary artery pressure, radial arterial pressure, ventilation rate, cardiac output, PaO2, and work rate at exhaustion before and after administration of the drug riociguat. The investigator's hypothesis is that riociguat will decrease pulmonary artery pressure and improve gas exchange and exercise performance at altitude.
>Trial ID>Title>Status>Phase>Start Date>Summary
Showing 1 to 5 of 5 entries

Clinical Trial Conditions for ADEMPAS

Condition Name

53220-0.500.511.522.533.544.555.5Hypertension, PulmonaryPulmonary Arterial HypertensionChronic Thromboembolic Pulmonary HypertensionCTEPH[disabled in preview]
Condition Name for ADEMPAS
Intervention Trials
Hypertension, Pulmonary 5
Pulmonary Arterial Hypertension 3
Chronic Thromboembolic Pulmonary Hypertension 2
CTEPH 2
[disabled in preview] 0
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Condition MeSH

7753001234567HypertensionHypertension, PulmonaryPulmonary Arterial HypertensionFamilial Primary Pulmonary Hypertension[disabled in preview]
Condition MeSH for ADEMPAS
Intervention Trials
Hypertension 7
Hypertension, Pulmonary 7
Pulmonary Arterial Hypertension 5
Familial Primary Pulmonary Hypertension 3
[disabled in preview] 0
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Clinical Trial Locations for ADEMPAS

Trials by Country

+
Trials by Country for ADEMPAS
Location Trials
United States 27
Germany 3
Austria 2
United Kingdom 2
Italy 2
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Trials by US State

+
Trials by US State for ADEMPAS
Location Trials
North Carolina 3
Pennsylvania 2
New York 2
District of Columbia 2
California 2
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Clinical Trial Progress for ADEMPAS

Clinical Trial Phase

18.7%12.5%37.5%31.2%022.533.544.555.56Phase 4Phase 3Phase 2[disabled in preview]
Clinical Trial Phase for ADEMPAS
Clinical Trial Phase Trials
Phase 4 3
Phase 3 2
Phase 2 6
[disabled in preview] 5
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Clinical Trial Status

44.4%33.3%16.7%5.6%012345678CompletedRecruitingNot yet recruiting[disabled in preview]
Clinical Trial Status for ADEMPAS
Clinical Trial Phase Trials
Completed 8
Recruiting 6
Not yet recruiting 3
[disabled in preview] 1
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Clinical Trial Sponsors for ADEMPAS

Sponsor Name

trials01122334455667BayerMedical University of ViennaActelion[disabled in preview]
Sponsor Name for ADEMPAS
Sponsor Trials
Bayer 6
Medical University of Vienna 2
Actelion 2
[disabled in preview] 2
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Sponsor Type

65.4%34.6%0024681012141618OtherIndustry[disabled in preview]
Sponsor Type for ADEMPAS
Sponsor Trials
Other 17
Industry 9
[disabled in preview] 0
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Adempas: Clinical Trials, Market Analysis, and Projections

Introduction to Adempas

Adempas, also known by its generic name riociguat, is a guanylyl cyclase stimulator used in the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Here, we will delve into the clinical trials that led to its approval, its current market standing, and future projections.

Clinical Trials: PATENT-1 and PATENT-2

PATENT-1 Trial

The approval of Adempas for PAH was primarily based on the results of the PATENT-1 trial, a double-blind, multi-national, multi-center phase 3 clinical study. This trial involved 443 patients with symptomatic PAH who were randomized to receive either Adempas (at doses of 2.5 mg or 1.5 mg three times a day) or a placebo for 12 weeks[1][4].

  • Primary Outcome: The primary outcome measure was the change in the 6-minute walk distance (6MWD) from baseline to week 12. Patients treated with 2.5 mg of Adempas showed a mean increase of 30 meters in 6MWD, while those receiving the placebo experienced a mean decrease of 6 meters[1][4].
  • Secondary Outcomes: Significant improvements were also observed in pulmonary vascular resistance, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, World Health Organization (WHO) functional class, time to clinical worsening, and Borg dyspnea score[1][4].

PATENT-2 Trial

The PATENT-2 trial was an open-label extension of PATENT-1, where 98% of the patients who completed PATENT-1 entered this long-term study. The analysis showed sustained benefits in WHO functional class and 6MWD over up to one year. The mean treatment duration was 663 days, with a 97% survival rate at one year and 93% at two years[1].

Safety and Efficacy

Adverse Events

The most common serious adverse event reported in both the PATENT-1 and PATENT-2 trials was syncope. Additionally, serious bleeding occurred in 2.4% of patients taking Adempas compared to 0% in the placebo group[4].

Contraindications and Precautions

Adempas is contraindicated in patients taking certain medications such as phosphodiesterase-5 inhibitors (PDE5is), soluble guanylate cyclase stimulators, and nitrates. It is also not recommended for patients with systolic blood pressure below 95 mmHg[1].

Market Analysis

Current Market Standing

Adempas is part of the guanylyl cyclase stimulator (GCS) class, which, although small, has been gaining market share. Historically, endothelin receptor antagonists (ERAs) were the most commercially lucrative class, but in 2019, prostacyclins surpassed them with total sales of $2,675 million compared to $2,286 million for ERAs[2][3].

  • Market Share: Adempas has been holding steady, particularly among patients who respond poorly to PDE5is. However, its market share is limited compared to other classes like prostacyclins and ERAs[2].

Competition and Challenges

Bayer, the manufacturer of Adempas, faced significant challenges, including a slow start and a canceled trial due to safety concerns. This canceled trial, which aimed to expand the label to include PAH patients with idiopathic interstitial pneumonias, impacted the drug's growth expectations. Analysts now predict Adempas will achieve $459 million in sales by 2022, far below the initial expectations of $870 million by 2018[5].

  • Competitors: The PAH market is highly competitive, with other drugs like Opsumit and Uptravi from Actelion gaining significant market share. These drugs have strong positioning in treatment guidelines and robust efficacy data, making them formidable competitors[3][5].

Market Projections

Future Growth

Despite current challenges, Adempas still holds potential for growth, particularly if additional larger trials demonstrate significant clinical benefits. Here are some key projections:

  • Market Trends: The gap between prostacyclins and ERAs is expected to widen further, with prostacyclins likely to dominate the market due to their increasing use in triple combination therapies[2][3].
  • Sales Projections: While Adempas may not meet the initial high growth expectations, it can still contribute to Bayer's portfolio, especially if it can carve out a niche among patients who do not respond well to other treatments[5].

Key Takeaways

  • Clinical Efficacy: Adempas has shown significant improvements in 6MWD, WHO functional class, time to clinical worsening, and other key parameters in clinical trials.
  • Market Position: Despite challenges, Adempas holds a unique position in the PAH market, particularly for patients who do not respond to PDE5is.
  • Future Growth: The drug's growth potential depends on additional clinical trials and its ability to compete with other market leaders.

FAQs

Q: What is Adempas used for?

A: Adempas (riociguat) is used for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

Q: What were the key findings of the PATENT-1 trial?

A: The PATENT-1 trial showed significant improvements in 6MWD, pulmonary vascular resistance, NT-proBNP levels, WHO functional class, and time to clinical worsening in patients treated with Adempas.

Q: What are the common adverse events associated with Adempas?

A: The most common serious adverse event reported was syncope, and serious bleeding occurred in 2.4% of patients taking Adempas.

Q: How does Adempas compare to other PAH treatments in the market?

A: Adempas is part of the GCS class and has been gaining market share, particularly among patients who respond poorly to PDE5is, but it faces strong competition from prostacyclins and ERAs.

Q: What are the future growth projections for Adempas?

A: Despite current challenges, Adempas can still grow if additional trials demonstrate significant clinical benefits, and it can carve out a niche in the market.

References

  1. Adempas - Rare Disease Advisor: https://www.rarediseaseadvisor.com/therapies/adempas-riociguat/
  2. Global Pulmonary Arterial Hypertension Market and Forecast Analysis Report 2021-2027: https://www.businesswire.com/news/home/20210608005667/en/Global-Pulmonary-Arterial-Hypertension-Market-and-Forecast-Analysis-Report-2021-2027---ResearchAndMarkets.com
  3. Global Pulmonary Arterial Hypertension Market Report 2021: https://www.globenewswire.com/news-release/2021/06/09/2244413/28124/en/Global-Pulmonary-Arterial-Hypertension-Market-Report-2021-Market-Leaders-Opsumit-and-Uptravi-are-Being-Investigated-in-Clinical-Trials-to-Potentially-Support-Label-Expansions-to-CT.html
  4. Adempas (riociguat) | Efficacy + Results: https://www.adempashcp.com/pah-efficacy
  5. Can Adempas meet Bayer's growth expectations after a canceled trial?: https://www.fiercepharma.com/marketing/can-adempas-meet-bayer-s-growth-expectations-after-a-canceled-trial

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