Adempas® (riociguat) Patient Profiles

Meet Craig, age 48

EVALUATING AT DIAGNOSIS

PAH (WHO Group 1) WHO FC II
6MWD 376 m NT-proBNP 1089 pb/mL

Craig’s ready to coach some winning games with first-line treatment with Adempas:

After coaching his son at soccer practice, Craig experienced shortness of breath that he wasn’t
used to. After talking with his GP, Craig was evaluated at a PH center and was diagnosed with PAH. His physician decided to start him on Adempas and an ERA.

Craig is ready to get back to coaching on the sidelines

6MWD = 6-minute walking distance; ERA = endothelin receptor antagonist; NT-proBNP = N-terminal pro-brain natriuretic peptide; PAH = pulmonary arterial hypertension; PH = pulmonary hypertension; WHO FC = World Health Organization Functional Class.

Help patients like Craig get back to
spending time with their teams

SEE PAH RESULTS

Have you considered transitioning patients to Adempas in your practice?

Meet Patricia, age 48

EVALUATING AT DIAGNOSIS

PAH (WHO Group 1) WHO FC II
6MWD 376 m NT-proBNP 304 pb/mL

Patricia is excited to compete in her town’s garden club contest:

Diagnosed with PAH 2 years ago, Patricia’s PH specialist had placed her on PAH therapies. While preparing her garden, Patricia noticed worsening shortness of breath with chest pain and fatigue, forcing her to leave her garden beds untended to. At her last follow-up visit with her PH specialist, tests confirmed that her PAH had not improved. Then her specialist decided it was time to initiate treatment with Adempas.

Patricia’s confident in winning a blue ribbon

6MWD = 6-minute walking distance; NT-proBNP = N-terminal pro-brain natriuretic peptide; PAH = pulmonary arterial hypertension; PH = pulmonary hypertension; WHO FC = World Health Organization Functional Class.

Help patients like Patricia so they
can watch their gardens bloom

SEE REPLACE STUDY RESULTS

She is surgically inoperable. How would you manage her CTEPH diagnosis?

Meet Cassie, age 59

EVALUATING AT DIAGNOSIS

CTEPH (WHO Group 4) WHO FC III
6MWD 347 m PVR 791 mL dyn∙sec∙cm^-5

Cassie’s goal is to take a stroll:

Every morning, Cassie takes her new puppy on a walk around the block. Recently, she fainted while on her usual route. She shortly scheduled an appointment with her PCP, and then a specialist, who referred her to a CTEPH center of excellence for further evaluation. Shortly after, Cassie was diagnosed with CTEPH and underwent an operability assessment but was adjudicated as inoperable. Her physician decided to start her on Adempas, the first and only approved treatment for CTEPH(WHO Group 4).^*

Cassie and her puppy are ready to get back to playing fetch

Help patients like Cassie so
they can keep striding along

SEE CTEPH RESULTS

Meet Craig, age 48

EVALUATING AT DIAGNOSIS

PAH (WHO Group 1)

WHO FC II

6MWD 376 m

NT-proBNP 304 pb/mL

Craig’s ready to coach some winning games with first-line treatment with Adempas:

After coaching his son at soccer practice, Craig experienced shortness of breath that he wasn’t used to. After talking with his GP, Craig was evaluated at a PH center and was diagnosed with PAH. His physician decided to start him on Adempas and an ERA.

Craig is ready to get back to coaching on the sidelines

6MWD = 6-minute walking distance; ERA = endothelin receptor antagonist; NT-proBNP = N-terminal pro-brain natriuretic peptide; PAH = pulmonary arterial hypertension; PH=pulmonary hypertension; WHO FC = World Health Organization Functional Class.

Have you considered transitioning patients to Adempas in your practice?

Meet Patricia, age 48

EVALUATING AT DIAGNOSIS

PAH (WHO Group 1)

WHO FC II

6MWD 376 m

NT-proBNP 304 pb/mL

Patricia is excited to compete in her town’s garden club contest:

Patricia’s confident in winning a blue ribbon

6MWD = 6-minute walking distance; ERA = endothelin receptor antagonist; NT-proBNP = N-terminal pro-brain natriuretic peptide; PAH = pulmonary arterial hypertension; PH=pulmonary hypertension; WHO FC = World Health Organization Functional Class

She is surgically inoperable. How would you manage her CTEPH diagnosis?

Meet Patricia, age 48

EVALUATING AT DIAGNOSIS

PAH (WHO Group 1)

WHO FC II

6MWD 376 m

NT-proBNP 304 pb/mL

Cassie’s goal is to take a stroll:

Craig is ready to get back to coaching on the sidelines

6MWD = 6-minute walking distance; ERA = endothelin receptor antagonist; NT-proBNP = N-terminal pro-brain natriuretic peptide; PAH = pulmonary arterial hypertension; PH=pulmonary hypertension; WHO FC = World Health Organization Functional Class.

MORE IMPORTANT SAFETY INFORMATION LESS IMPORTANT SAFETY INFORMATION

Important Safety Information and Indications

WARNING: EMBRYO-FETAL TOXICITY

Do not administer Adempas (riociguat) tablets to a pregnant female because it may cause fetal harm.

Females of reproductive potential: Exclude pregnancy before the start of treatment, monthly during treatment, and one month after stopping treatment. To prevent pregnancy, females of reproductive potential must use effective forms of contraception during treatment and for one month after stopping treatment.

For all female patients, Adempas is available only through a restricted program called the Adempas Risk Evaluation and Mitigation Strategy (REMS) Program.

Contraindications

Adempas is contraindicated in:

Pregnancy. Based on data from animal reproduction studies, Adempas may cause fetal harm when administered to a pregnant woman and is contraindicated in females who are pregnant. Adempas was consistently shown to have teratogenic effects when administered to animals. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
Co-administration with nitrates or nitric oxide donors (such as amyl nitrite) in any form.
Concomitant administration with specific phosphodiesterase (PDE)-5 inhibitors (such as sildenafil, tadalafil, or vardenafil) or nonspecific PDE inhibitors (such as dipyridamole or theophylline) is contraindicated. Do not administer within 24 hours of sildenafil. Do not administer 24 hours before or within 48 hours after tadalafil.
Patients with concomitant use of other soluble guanylate cyclase (sGC) stimulators.
Patients with Pulmonary Hypertension associated with Idiopathic Interstitial Pneumonias (PH-IIP).

Warnings and Precautions

Embryo-Fetal Toxicity. Based on data from animal reproduction studies, Adempas may cause embryo-fetal toxicity when administered to a pregnant female and is contraindicated in females who are pregnant. Advise females of reproductive potential of the potential risk to a fetus. Obtain a pregnancy test before the start of treatment, monthly during treatment, and for one month after stopping treatment. Advise females of reproductive potential to use effective contraception during treatment with Adempas and for at least one month after the last dose.

For females, Adempas is only available through a restricted program under the Adempas REMS Program.

Adempas REMS Program. Females can only receive Adempas through the Adempas REMS Program, a restricted distribution program.

Important requirements of the Adempas REMS Program include the following:

Prescribers must be certified with the program by enrolling and completing training.
All females, regardless of reproductive potential, must enroll in the Adempas REMS Program prior to initiating Adempas. Male patients are not enrolled in the Adempas REMS Program.
Female patients of reproductive potential must comply with the pregnancy testing and contraception requirements.
Pharmacies must be certified with the program and must only dispense to patients who are authorized to receive Adempas.

Further information, including a list of certified pharmacies, is available at www.AdempasREMS.com or 1-855-4ADEMPAS.

Hypotension. Adempas reduces blood pressure. Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors. Consider a dose reduction if patient develops signs or symptoms of hypotension.

Bleeding. In the placebo-controlled clinical trials, serious bleeding occurred in 2.4% of patients taking Adempas compared to 0% of placebo patients. Serious hemoptysis occurred in 5 (1%) patients taking Adempas compared to 0 placebo patients, including one event with fatal outcome. Serious hemorrhagic events also included 2 patients with vaginal hemorrhage, 2 with catheter-site hemorrhage, and 1 each with subdural hematoma, hematemesis, and intra-abdominal hemorrhage.

Pulmonary Veno-Occlusive Disease. Pulmonary vasodilators may significantly worsen the cardiovascular status of patients with pulmonary veno-occlusive disease (PVOD). Therefore, administration of Adempas to such patients is not recommended. Should signs of pulmonary edema occur, the possibility of associated PVOD should be considered and if confirmed, discontinue treatment with Adempas.

Most Common Adverse Reactions

The most common adverse reactions occurring more frequently (≥3%) on Adempas than placebo were headache (27% vs 18%), dyspepsia/gastritis (21% vs 8%), dizziness (20% vs 13%), nausea (14% vs 11%), diarrhea (12% vs 8%), hypotension (10% vs 4%), vomiting (10% vs 7%), anemia (7% vs 2%), gastroesophageal reflux disease (5% vs 2%), and constipation (5% vs 1%).

Other events that were seen more frequently in Adempas compared to placebo and potentially related to treatment were palpitations, nasal congestion, epistaxis, dysphagia, abdominal distension, and peripheral edema.

Indications

Adempas (riociguat) is indicated for the treatment of adults with persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) (WHO Group 4) after surgical treatment or inoperable CTEPH to improve exercise capacity and WHO functional class.
Adempas is indicated for the treatment of adults with pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise capacity, improve WHO functional class and to delay clinical worsening.*

Efficacy was shown in patients on Adempas monotherapy or in combination with endothelin receptor antagonists or prostanoids. Studies establishing effectiveness included predominantly patients with WHO functional class II–III and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (25%).

^*Time to clinical worsening was a combined endpoint defined as death (all-cause mortality), heart/lung transplantation, atrial septostomy, hospitalization due to persistent worsening of pulmonary hypertension, start of new PAH-specific treatment, persistent decrease in 6MWD, and persistent worsening of WHO functional class.

For important risk and use information, please see the full Prescribing Information, including Boxed Warning.

Reference:

Adempas Prescribing Information. Whippany, NJ. Bayer Pharmaceuticals Inc., 2023.

ADEMPAS PATIENT PROFILES

Do you see patients like this in your practice?Not actual patients.

WARNING: EMBRYO-FETAL TOXICITY