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Vericiguat

Phase 2

Chronic Heart Failure With Reduced Ejection Fraction | Small molecule | Cardiovascular |Bayer AG|Last Updated: Jan 28, 2026

Target and mechanism

Molecular targetGUCY1B1, GUCY1A2, GUCY1A1
Target classActivator
ModalitySmall molecule

Also known as Vericiguat Oral Tablet

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLED
Total Trials1
Total Enrollment106

FDA Designations

No designations recorded

Clinical trial landscape

Vericiguat · 7 trials · 4 indications

Phase 2 4Phase 1 3
NCT06195930A Study to Learn How Safe Starting Vericiguat at a Dose of 5 Milligrams is in Participants With Chronic Heart Failure With Reduced Ejection FractionChronic Heart Failure With Reduced Ejection Fraction
COMPLETED106 Analytics
NCT05697640Study to Investigate Improvement in Physical Function in SF-36 With Vericiguat Compared With Placebo in Participants With Post-COVID-19 SyndromePost-COVID ME/CFS
ACTIVE NOT_RECRUITING104 Analytics
NCT01951625Phase IIb Safety and Efficacy Study of Four Dose Regimens of BAY1021189 in Patients With Heart Failure With Reduced Ejection Fraction Suffering From Worsening Chronic Heart Failure (SOCRATES-REDUCED)Heart Failure
COMPLETED456 Analytics
NCT01951638Phase IIb Safety and Efficacy Study of Four Dose Regimens of BAY1021189 in Patients With Heart Failure and Preserved Ejection Fraction Suffering From Worsening Chronic Heart Failure (SOCRATES-PRESERVED)Heart Failure
COMPLETED477 Analytics
PHASE2COMPLETED
A Study to Learn How Safe Starting Vericiguat at a Dose of 5 Milligrams is in Participants With Chronic Heart Failure With Reduced Ejection Fraction
Chronic Heart Failure With Reduced Ejection FractionUnlock trial analytics
PHASE2ACTIVE NOT_RECRUITING
Study to Investigate Improvement in Physical Function in SF-36 With Vericiguat Compared With Placebo in Participants With Post-COVID-19 Syndrome
Post-COVID ME/CFSUnlock trial analytics
PHASE2COMPLETED
Phase IIb Safety and Efficacy Study of Four Dose Regimens of BAY1021189 in Patients With Heart Failure With Reduced Ejection Fraction Suffering From Worsening Chronic Heart Failure (SOCRATES-REDUCED)
Heart FailureUnlock trial analytics
PHASE2COMPLETED
Phase IIb Safety and Efficacy Study of Four Dose Regimens of BAY1021189 in Patients With Heart Failure and Preserved Ejection Fraction Suffering From Worsening Chronic Heart Failure (SOCRATES-PRESERVED)
Heart FailureUnlock trial analytics

Study Endpoints

Primary Endpoints

Treatment Tolerability: Number of Participants Without Discontinuation of Study Intervention (Incl. Max. 1 Day Interruption) and Without Moderate to Severe Symptomatic Hypotension
Between Visit 1 (Day 1) and Visit 2 (Day 14 up to Day 18 if +4 days time window is used)

Treatment tolerability, defined as the completion of the two-week 5 mg dose without discontinuation of study intervention (incl. max. 1 day interruption) and without moderate to severe symptomatic hypotension between Visit 1 and Visit 2

Treatment Tolerability: Number of Participants Without Discontinuation of Study Intervention (Max. 2 Day Interruption Included) and Without Moderate to Severe Symptomatic Hypotension
Between Visit 1 (Day 1) and Visit 2 (Day 14 up to Day 18 if +4 days time window is used)

Treatment tolerability, defined as the completion of the two-week 5 mg dose without discontinuation of study intervention (incl. max. 2 day interruption) and without moderate to severe symptomatic hypotension between Visit 1 and Visit 2

Improvement in Physical Function (PF) as measured by the Short Form 36 Health Survey Questionnaire (SF-36)
10 weeks after first IMP intake

The Short Form 36 Health Survey (SF-36) is an established and widely used health-related quality of life measure. The Physical Function (PF) domain asks patients to report limitations on ten mobility activities, such as walking specified distances, carrying groceries, and bathing or dressing. Scores are weighted and transformed into a scale ranging from 0 (greatest possible health restrictions, i.e., severe disability) to 100 (no health restrictions). An intra-patient change of 10 points in SF-36-PF from baseline to week ten is considered clinically meaningful.

Change From Baseline in Log-Transformed N-Terminal Pro-Brain Natriuretic Peptide (NTproBNP) to Week 12
Baseline, Week 12

Log-Transformed N-Terminal Pro-Brain Natriuretic Peptide (NTproBNP) is a circulating plasma biomarker of cardiovascular function and prognosis in heart failure.

Change From Baseline to Week 12 in Log-transformed N-terminal Pro-brain Natriuretic Peptide (NT-proBNP)
Baseline, Week 12 (end of treatment [EOT])

NTproBNP is a circulating plasma biomarker of cardiovascular function and prognosis in heart failure (HF).

Change From Baseline to Week 12 in Left Atrial Volume (LAV)
Baseline, Week 12 (EOT)

Left atrial volume was measured by echocardiography.

Time-matched placebo-corrected change from baseline of the QT interval corrected according to Fridericia (QTcF) after 10 mg vericiguat at steady state.
Baseline, day 56 (steady state 10 mg) of vericiguat treatment
Number of participants with adverse events as measure of safety and tolerability
approximately 1 year
AUC of vericiguat
Up to 96 hours

Area under the concentration vs. time curve from zero to infinity after single dose administration

AUCu of vericiguat
Up to 96 hours

AUC unbound

Cmax of vericiguat
Up to 96 hours

Maximum observed drug concentration in measured matrix after single dose administration

Cmax,u of vericiguat
Up to 96 hours

Cmax unbound

Secondary Endpoints

Number of Participants With Any Adverse Event (AE) Reported Between Visit 1 and Visit 2
Between Visit 1 (Day 1) and Visit 2 (Day 14 up to Day 18 if +4 days time window is used)
Number of Participants With no AE Related to Study Intervention Between Visit 1 and Visit 2
Between Visit 1 (Day 1) and Visit 2 (Day 14 up to Day 18 if +4 days time window is used)
Number of Participants With Continuous Intake of Study Intervention Between Visit 1 and Visit 2 or Restart of Study Intervention After Any Temporary Interruption.
Between Visit 1 (Day 1) and Visit 2 (Day 14 up to Day 18 if +4 days time window is used)
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Overall studyEXPERIMENTALAt Visit 1 participants will receive 1x 5 mg Vericiguat (BAY1021189) tablet daily (on top of standard of care) for at least 14 days to max 18 days (+4 days time window allowed)
Vericiguat Oral TabletACTIVE_COMPARATORTested IMP: Vericiguat (film-coated tablet). Authorization status: Not authorised in this targeted therapeutic indication; Vericiguat is authorized for the dosages that will be administered in this trial for another indication. The tablets used in this trial are no trade product, but a special trial product produced and provided by the marketing authorization holder Bayer. Administration: Once daily (oral). Planned dosage: Three different dosages starting with 2.5 mg for two weeks, followed by 5 mg for two weeks and 10 mg for six weeks. The general IMP titration regimen was investigated and proven to be safe (max. dosages 10 mg/day) in patients with heart failure and reduced ejection fraction (Armstrong et al., 2020).
Placebo Oral TabletPLACEBO_COMPARATORComparator IMP: Placebo (film-coated tablet). Authorization status: Not authorised. The tablets used in this trial are no trade product, but a special trial product produced and provided by the marketing authorization holder Bayer. Administration: Once daily (oral). Planned dosage: Three different dosages starting with 2.5 mg for two weeks, followed by 5 mg for two weeks and 10 mg for six weeks to have identical conditions to verum.
Vericiguat (BAY1021189) (10 mg)EXPERIMENTAL2.5 mg orally once daily for 2 weeks, up-titration to 5 mg orally once daily for 2 weeks, up-titration to 10 mg orally once daily for 8 weeks
Vericiguat (BAY1021189) (5 mg)EXPERIMENTAL2.5 mg orally once daily for 2 weeks, then 5 mg orally once daily for 10 weeks (with sham titration)
Vericiguat (BAY1021189) (2.5 mg)EXPERIMENTAL2.5 mg orally once daily for 12 weeks (with sham titrations)
Vericiguat (BAY1021189) (1.25 mg)EXPERIMENTAL1.25 mg orally once daily for 12 weeks (with sham titrations)
PlaceboPLACEBO_COMPARATOROrally once daily for 12 weeks (with sham titrations)
Vericiguat (BAY1021189)(10 mg)EXPERIMENTAL2.5 mg orally once daily for 2 weeks, up-titration to 5 mg orally once daily for 2 weeks, up-titration to 10 mg orally once daily for 8 weeks
Treatment 1EXPERIMENTALTreatment sequences: A\*-B-C-D
Treatment 2EXPERIMENTALTreatment sequences: D-A-B-C\*
Vericiguat + NitroglycerinEXPERIMENTALCo-administration of vericiguat and nitroglycerin
Placebo + NitroglycerinPLACEBO_COMPARATORAministration of matching placebo and nitroglycerin.
Child Pugh AEXPERIMENTALParticipants with mild hepatic impairment
Child Pugh BEXPERIMENTALParticipants with moderate hepatic impairment
Healthy participantsEXPERIMENTALParticipants with normal hepatic function

Interventions

NameTypeDescription
Vericiguat (BAY1021189) 5 mgDRUGVericiguat (BAY1021189) will be taken as 5 mg tablet 1x daily over at least 14 days up to 18 days (+ 4 days time window allowed)
Vericiguat Oral TabletDRUGThe treatment period includes ten weeks of daily vericiguat or placebo intake (depending on randomization) and a 30-day follow-up period (no vericiguat/placebo intake).
Vericiguat (BAY1021189) (1.25 mg)DRUG1.25 mg BAY1021189 tablets
Vericiguat (BAY1021189) (5 mg)DRUG5 mg BAY1021189 tablets
PlaceboDRUG -
Vericiguat (BAY1021189)DRUGA : 2.5 mg vericiguat A\*: 2.5 mg vericiguat B : 5 mg vericiguat C : 10 mg vericiguat C\*: 10 mg vericiguat
MoxifloxacinDRUGD: 400 mg moxifloxacin
NitroglycerinDRUG0.4 mg nitroglycerin spray administered at 2.5 hours before treatment (vericiguat \[trough\] or placebo) on day 12, day 26 and day 40 at 4 hours after treatment (vericiguat \[peak\] or placebo) on day 13, day 27 and day 41
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites35

Inclusion Criteria: * Has an Left ventricle ejection fraction (LVEF) of \<45% assessed within 12 months before Visit 1 by local any imaging method, and no subsequent LVEF measurement \> 45%. The most recent measurement must be used to determine eligibility. * systolic blood pressure (SBP) ≥ 100 mmH...

Countries:United StatesArgentinaHungaryItalyPolandSpainSwedenGermanyAustraliaAustriaBelgiumBulgariaCanadaCzechiaDenmarkFranceGreeceIsraelJapanNetherlandsSingaporeSouth KoreaSwitzerlandTaiwanUnited KingdomPortugalMoldova
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Frequently asked questions about Vericiguat

What is Vericiguat used for?

Vericiguat is an investigational small molecule being studied for cardiovascular conditions including heart failure, coronary artery disease, and chronic heart failure with reduced ejection fraction, as well as post-COVID ME/CFS. It is in Phase 2 clinical development and is not yet approved by the FDA.

Who makes Vericiguat?

Vericiguat is being developed by Bayer AG, which trades under the ticker BAYRY. The drug is currently in Phase 2 clinical trials for multiple cardiovascular indications and post-COVID ME/CFS.

What phase is Vericiguat in?

Vericiguat is in Phase 2 clinical development. It is an investigational drug and has not received FDA approval. Clinical trials are ongoing or completed across several indications including chronic heart failure with reduced ejection fraction and post-COVID ME/CFS.

What clinical trials is Vericiguat in?

Vericiguat has been studied in several clinical trials. NCT05697640 is an active Phase 2 trial in post-COVID ME/CFS. Completed trials include NCT06195930 in chronic heart failure with reduced ejection fraction, and Phase 1 trials NCT02617550 and NCT03504982 in coronary artery disease.

Is Vericiguat the same as Vericiguat Oral Tablet?

Yes, Vericiguat is also known as Vericiguat Oral Tablet. The drug is administered orally and is being developed by Bayer AG for cardiovascular conditions and post-COVID ME/CFS.