Switching from Sildenafil to Riociguat for CTEPH Patients

Switching Sildenafil to Riociguat in Chronic Thromboembolic Pulmonary Hypertension After Balloon Pulmonary Angioplasty

Phase 4 Interventional Chinese University of Hong Kong · NCT06715280

This study is testing if switching from sildenafil to riociguat can help people with Chronic Thromboembolic Pulmonary Hypertension feel better after they’ve already had balloon pulmonary angioplasty.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment30 (estimated)
Ages18 Years and up
SexAll
SponsorChinese University of Hong Kong Academic / other
Locations1 site (Hong Kong)
Trial IDNCT06715280 on ClinicalTrials.gov

What this trial studies

This study investigates the safety and efficacy of replacing phosphodiesterase 5 inhibitors (PDE5i) with riociguat in patients suffering from Chronic Thromboembolic Pulmonary Hypertension (CTEPH) who remain symptomatic after undergoing balloon pulmonary angioplasty (BPA). The trial aims to determine if riociguat can provide better outcomes for these patients compared to continued treatment with PDE5i. It focuses on patients who have been on a stable dose of sildenafil for at least six weeks and are classified as WHO functional class III. The study is crucial as it addresses a significant gap in treatment options for those with inoperable CTEPH.

Who should consider this trial

Good fit: Ideal candidates are patients diagnosed with CTEPH who are symptomatic after BPA and have been on a stable dose of sildenafil.

Not a fit: Patients who have previously been treated with riociguat or have severe drug reactions to soluble guanylate cyclase stimulators may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could improve symptoms and quality of life for patients with CTEPH who do not respond adequately to current treatments.

How similar studies have performed: Previous studies have shown that riociguat can significantly improve outcomes in patients with inoperable CTEPH, indicating potential success for this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Patients with established diagnosis of CTEPH who are symptomatic after Balloon pulmonary angioplasty (BPA)
2. Patients who are on stable maximally tolerated dose of sildenafil for at least 6 weeks as monotherapy, or in combination with other pulmonary hypertension specific therapies
3. WHO functional class III at screening
4. Stable dose of diuretics (if used) for at least 30 days at screening
5. No recent hospitalisation due to pulmonary hypertension or heart failure for at least 30 days

Exclusion Criteria:

1. Previous treatment with riociguat other sGCs, or documented severe drug reaction or intolerance to sGCs
2. Use of nitrates or nitric oxide donors (eg, nitroglycerin, amyl nitrite, isosorbide dinitrate etc) by any administration routes within 30 days of screening
3. Pregnant women or breast-feeding women, or women with childbearing potential not using of combination of two effective contraception methods throughout study
4. Renal impairment with glomerular filtration rate \<15mL /min
5. Child-Pugh C hepatic impairment

Where this trial is running

Hong Kong

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Chronic Thromboembolic Pulmonary HypertensionCTEPHBPARiociguatSildenafil
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.