Riociguat-Discontinue Effects on Right HEART in CTEPH (RED-HEART)

NCT ID: NCT06922240

Last Updated: 2025-04-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

68 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-21

Study Completion Date

2027-10-31

Brief Summary

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Riociguat and balloon pulmonary angioplasty (BPA) are established standard-of-care interventions for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) with comparable evidence levels. However, the optimal combined treatment strategy remains unclear. Specifically, there is no consensus on whether riociguat should be continued long-term after achieving hemodynamic stability with BPA. Additionally, the long-term effects of riociguat discontinuation on right ventricular (RV) structure and function remain poorly characterized, particularly due to the lack of comprehensive noninvasive evaluations integrating cardiac magnetic resonance (CMR) and echocardiography. This prospective study aims to determine the hemodynamic impact of riociguat discontinuation in inoperable CTEPH patients who have achieved BPA treatment endpoints using right heart catheterization (RHC). Evaluate RV remodeling and functional changes after riociguat cessation through multimodal noninvasive imaging (CMR, echocardiography). Assess safety outcomes and identify potential rebound pulmonary hypertension or decompensated RV dysfunction associated with riociguat withdrawal.

Detailed Description

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Conditions

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Chronic Thromboembolic Pulmonary Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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riociguat group

The subject was given comprehensive treatment in accordance with the guidelines and oral riociguat.

Group Type ACTIVE_COMPARATOR

Riociguat

Intervention Type DRUG

On the basis of the comprehensive treatment in line with the guidelines, including conventional diuresis, anticoagulation, oxygen inhalation, etc., continue oral administration of riociguat for treatment.

routine treatment group

The subject was given comprehensive treatment in accordance with the guidelines.

Group Type EXPERIMENTAL

Routine Treatment

Intervention Type DRUG

On the basis of the comprehensive treatment in line with the guidelines, including conventional diuresis, anticoagulation, oxygen inhalation, etc, and stop taking riociguat

Interventions

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Riociguat

On the basis of the comprehensive treatment in line with the guidelines, including conventional diuresis, anticoagulation, oxygen inhalation, etc., continue oral administration of riociguat for treatment.

Intervention Type DRUG

Routine Treatment

On the basis of the comprehensive treatment in line with the guidelines, including conventional diuresis, anticoagulation, oxygen inhalation, etc, and stop taking riociguat

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years old
* CTEPH was diagnosed and one of the following three factors was met: Pulmonary endarterectomy was technically impossible; Pulmonary endarterectomy is technically feasible, but the risk-benefit ratio is poor; Residual/recurrent pulmonary hypertension after pulmonary endarterectomy
* Subjects had been treated with BPA and had received a stable dose of riociguat for ≥12 weeks
* mPAP \< 30mmHg
* Male subjects and female subjects of reproductive age are required to use effective contraception for at least 28 days after signing the informed consent form. Male subjects are not allowed to donate sperm and female subjects are not allowed to breastfeed.
* Subjects voluntarily sign written informed consent

Exclusion Criteria

* Severe hepatic and renal insufficiency (Child-Pugh Grade C/creatinine clearance \< 30ml/min·1.73m²)
* The presence of severe infectious disease or severe bleeding tendency
* Combined with pulmonary hypertension of other types than CTEPH
* Other pulmonary hypertension targeting drugs are being used
* The expected survival time with cancer or other diseases is less than 6 months
* Pregnancy, lactation
* Subjects are currently participating in an interventional clinical trial
* In the investigator's judgment, a subject's medical abnormality, physical condition, or medical history may affect his or her ability to participate in or complete the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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China-Japan Friendship Hospital

OTHER

Sponsor Role collaborator

Beijing Anzhen Hospital

OTHER

Sponsor Role collaborator

Suqiao Yang

OTHER

Sponsor Role lead

Responsible Party

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Suqiao Yang

professor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Beijing Chao-Yang Hospital

Beijing, China, China

Site Status RECRUITING

China-Japan Friendship Hospital

Beijing, China, China

Site Status RECRUITING

Beijing Anzhen Hospital

Beijing, China, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Suqiao Yang

Role: CONTACT

010-85231217

Facility Contacts

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Guangxu Liu, Dr.

Role: primary

+861085231129

Shuai Zhang, Dr.

Role: primary

+8618501259164

Meng Zhang, Dr.

Role: primary

+8613552325192

Other Identifiers

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BRWEP2024W112030108

Identifier Type: -

Identifier Source: org_study_id

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