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Vericiguat

Phase 3

Heart Failure | Small molecule | Cardiovascular |Merck & Company, Inc.|Last Updated: Jul 13, 2026

Success Probability
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Trial Design
RandomizedDouble-BlindCONTROLLEDDMC
Total Trials3
Total Enrollment5,431
FDA Designations
No designations recorded
Clinical trial landscape

Vericiguat · 6 trials · 6 indications

Phase 3 2Phase 2 2Phase 1 2
NCT05093933A Study of Vericiguat (MK-1242) in Participants With Chronic Heart Failure With Reduced Ejection Fraction (HFrEF) (MK-1242-035)Chronic Heart Failure With Reduced Ejection Fraction
COMPLETED6,106 Analytics
NCT02861534A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction (HFrEF) (MK-1242-001)Heart Failure
COMPLETED5,050 Analytics
PHASE3COMPLETED
A Study of Vericiguat (MK-1242) in Participants With Chronic Heart Failure With Reduced Ejection Fraction (HFrEF) (MK-1242-035)
Chronic Heart Failure With Reduced Ejection FractionUnlock trial analytics
PHASE3COMPLETED
A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction (HFrEF) (MK-1242-001)
Heart FailureUnlock trial analytics
Study Endpoints
Primary Endpoints
Time to First Occurrence of Composite Endpoint of Cardiovascular (CV) Death or Heart Failure (HF) Hospitalization: Participants With an Event Per 100 Patient-Years
Up to approximately 36 months (from randomization to the primary completion data cutoff)

The time to first occurrence of the composite endpoint of CV death or HF hospitalization was defined as the time from randomization to the first event of CV death or HF hospitalization. Randomized participants without a HF hospitalization or CV death event at the time of analysis were censored at the last available information, when the protocol pre-specified number of total CV death events was achieved (primary completion analysis data cutoff), or the date of their non-CV death, whichever occurred first. Events were confirmed by a clinical events committee (CEC). Protocol-specified final analyses are reported here with a primary completion data cutoff. Time-to-event methodology was used to evaluate the results and the number of participants with a CV death or HF hospitalization event per 100 patient-years at risk is presented.

Time to First Occurrence of Composite Endpoint of Cardiovascular (CV) Death or Heart Failure (HF) Hospitalization
Up to approximately 33 months (through primary analysis database cutoff date of 18-June-2019)

Time to First Occurrence of Composite Endpoint of CV Death or HF Hospitalization was analyzed using a one-sided stratified log-rank test. Randomized participants without any HF hospitalization or CV death event at the time of analysis were censored at their last available information, the date of their non-CV death, or the primary analysis database cutoff date of 18-June-2019, whichever occurred first. A clinical events committee (CEC) reviewed and adjudicated the endpoint events. A time-to-event methodology was used to evaluate the results; the incidence rate of participants with an event (number of participants with an event per 100 participant-years at risk) is provided.

Absolute Change in Coronary Cross-sectional Area (in mm²) Within the Vericiguat Group as Assessed by Magnetic Resonance Imaging (MRI)
Baseline and 6 weeks following initiation of up-titrated dose

The difference in absolute change in coronary cross-sectional area (in mm²) from rest to isometric handgrip exercise (IHE) in the group randomized to vericiguat from that measured at baseline, prior to the initiation of vericiguat, to that measured at the end of the study drug administration period, six weeks following initiation of the titrated dose, as assessed by MRI.

Relative Change in Coronary Cross-sectional Area (as Percentage) Within the Vericiguat Group as Assessed by Magnetic Resonance Imaging (MRI)
Baseline and 6 weeks following initiation of up-titrated dose

The difference in relative change in coronary cross-sectional area (in %) from rest to isometric handgrip exercise (IHE) in the group randomized to vericiguat from that measured at baseline prior to the initiation of vericiguat, to that measured at the end of the study drug administration period, six weeks following initiation of the titrated dose, as assessed by MRI.

Absolute Change in Coronary Cross-sectional Area (in mm²) Between the Vericiguat Group and the Placebo Group as Assessed by Magnetic Resonance Imaging (MRI)
Baseline and 6 weeks following initiation of up-titrated dose

The difference in absolute change in coronary cross-sectional area (in mm²) from rest to isometric handgrip exercise (IHE) as assessed by MRI.

Difference in Percent Change in Coronary Cross-sectional Area (as Percentage) Between the Vericiguat Group and the Placebo Group as Assessed by Magnetic Resonance Imaging (MRI)
Baseline and 6 weeks following initiation of up-titrated dose

The difference in percentage change in coronary cross-sectional area (%) from rest to isometric handgrip exercise (IHE) between the vericiguat and placebo groups, as assessed from the baseline MRI to the follow-up MRI, six weeks following initiation of the titrated dose.

Base Period: Change from baseline to Week 16 in N-terminal pro-brain natriuretic peptide (NT-proBNP)
Baseline and Week 16 of Base Period

The change from baseline to Week 16 of the Base Period in log-transformed NT-proBNP will be reported.

Extension Period: Percentage of participants with one or more adverse events (AEs)
Includes data collected up to a maximum of approximately 8 years

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants with one or more AEs in the Extension Period will be reported.

Extension Period: Percentage of participants who discontinued study drug due to an AE
Includes data collected up to a maximum of approximately 8 years

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who discontinue study drug in the Extension Period due to an AE will be reported.

Blood pressure
Up to 8 weeks

Regular measurements of blood pressure after a vericiguat administration on the first and on the last days of each dose step of vericiguat, and on the first days of ISMN up-titration.

Heart rate
Up to 8 weeks

Regular measurements heart rate after a vericiguat administration on the first and on the last days of each dose step of vericiguat, and on the first days of ISMN up-titration.

AUC of vericiguat
Up to 96 hours

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

Cmax of vericiguat
Up to 96 hours

Maximum observed drug concentration in measured matrix after single dose administration

AUC of vericiguat's metabolite M-1
Up to 96 hours

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

Cmax of vericiguat's metabolite M-1
Up to 96 hours

Maximum observed drug concentration in measured matrix after single dose administration

Secondary Endpoints
Time to CV Death: Participants With an Event Per 100 Patient-Years
Up to approximately 36 months (from randomization to the primary completion data cutoff)
Time to First Occurrence of HF Hospitalization: Participants With an Event Per 100 Patient-Years
Up to approximately 36 months (from randomization to the primary completion data cutoff)
Time to Total HF Hospitalizations (Including First and Recurrent Events): Total Events Per 100 Patient-Years
Up to approximately 36 months (from randomization to the primary completion data cutoff)
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
VericiguatEXPERIMENTALParticipants receive a starting dose of 2.5 mg of vericiguat taken orally once daily. The vericiguat dose will be titrated to 5 mg and to 10 mg.
PlaceboPLACEBO_COMPARATORParticipants receive a starting matching placebo to vericiguat dose of 2.5 mg taken orally once daily. The matching placebo dose will be sham titrated to 5 mg and to 10 mg.
Base Period: VericiguatEXPERIMENTALParticipants in the Base Period receive 2.5 mg or 5 mg or 10 mg vericiguat administered orally once daily in tablet form for 52 weeks; or 0.2 mg/mL or 1 mg/mL vericiguat administered orally once daily in suspension form for 52 weeks.
Base Period: PlaceboPLACEBO_COMPARATORParticipants in the Base Period receive placebo for vericiguat administered orally once daily in tablet form for 52 weeks, or administered orally once daily in suspension form for 52 weeks.
Extension Period: VericiguatEXPERIMENTALParticipants in the Extension Period receive either 2.5 mg or 5 mg or 10 mg vericiguat administered orally once daily in tablet form; or 0.2 mg/mL or 1 mg/mL vericiguat administered orally once daily in suspension form; following completion of the Base Period.
Vericiguat + isosorbite mononitrateEXPERIMENTALSubjects received Isosorbide mononitrate (ISMN) up-titration with 30 mg / 60 mg, about 7 days each,prior to start of vericiguat administration. Then subjects received 2.5 mg vericiguat for about 14 days, followed by 5 mg vericiguat for about 14 days, followed by 10 mg vericiguat for about 14 days together 60 mg ISMN od on each day of vericiguat administration, taken 1 hour prior to vericiguat (in-house days) or together with vericiguat (out-patient days).
Placebo + isosorbite mononitratePLACEBO_COMPARATORSubjects received Isosorbide mononitrate (ISMN) up-titration with 30 mg / 60 mg, about 7 days each, prior to start of placebo administration. Then subjects received placebo matching 2.5 mg vericiguat for about 14 days, followed by placebo matching 5 mg vericiguat for about 14 days, followed by placebo matching 10 mg vericiguat for about 14 days together 60 mg ISMN od on each day of placebo administration, taken 1 hour prior to placebo (in-house days) or together with placebo (out-patient days).
Patients with normal creatine clearance (CLCR)EXPERIMENTALSubjects with renal impairment according to their medical history and estimated glomerular filtration rate (eGFR) at screening but had normal creatinine clearance at the pre-profile day (-01day)
Normal renal function (Healthy subjects)EXPERIMENTALSubjects with creatinine clearance at pre-profile day \>80 ml/min
Mildly impaired renal functionEXPERIMENTALSubjects with creatinine clearance at pre-profile day in the range of 50-80 ml/min
Moderately impaired renal functionEXPERIMENTALSubjects with creatinine clearance at pre-profile day in the range of 30-\<50 ml/min
Severely impaired renal functionEXPERIMENTALSubjects with creatinine clearance at pre-profile day \<30 ml/min
Interventions
NameTypeDescription
VericiguatDRUG2.5, 5.0, or 10.0 mg orally once daily
PlaceboDRUG0 mg matching placebo for 2.5 mg, 5 mg, and 10 mg of vericiguat
Placebo for vericiguatDRUG2.5, 5.0, or 10.0 mg orally once daily
Vericiguat tabletDRUG2.5 mg or 5 mg or 10 mg vericiguat administered orally once daily in tablet form
Vericiguat suspensionDRUG0.2 mg/mL or 1 mg/mL vericiguat administered orally once daily in suspension form
Placebo tabletDRUGPlacebo for vericiguat administered orally once daily in tablet form
Placebo suspensionDRUGPlacebo for vericiguat administered orally once daily in suspension form
Vericiguat (BAY1021189)DRUG2.5 mg/tablet; 5 mg/tablet or 10 mg/tablet
Isosorbide mononitrate (ISMN)DRUG30 mg/tablet or 60 mg/tablet
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Eligibility Criteria
Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites519

Inclusion Criteria: * History of chronic HF \[New York Heart Association (NYHA) Class II to IV\] on guideline-directed medical therapy for heart failure (GDMT) with no HF hospitalization within 6 months or outpatient IV diuretic use within 3 months before randomization. * Left ventricular ejection ...

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Recent Changes (Last 90 Days)
LOWJul 13, 2026NCT05714085lastUpdatePostDate: changed
LOWJul 13, 2026NCT05714085lastUpdatePostDate: changed
LOWJun 22, 2026NCT05714085lastUpdatePostDate: changed
LOWJun 22, 2026NCT05714085lastUpdatePostDate: changed
LOWMay 29, 2026NCT05714085lastUpdatePostDate: changed
LOWMay 29, 2026NCT05714085lastUpdatePostDate: changed
LOWMay 29, 2026NCT05714085lastUpdatePostDate: changed
LOWMay 26, 2026NCT05714085primaryCompletionDate: changed
LOWMay 24, 2026NCT05714085studyFirstPostDate: changed