Skip to main content
. Author manuscript; available in PMC: 2020 May 24.
Published in final edited form as: Circ Res. 2019 May 24;124(11):1618–1632. doi: 10.1161/CIRCRESAHA.119.313682

Table 1.

New pharmacologic signaling approaches for HFrEF under active clinical investigation

Drug class Proposed mechanism of action Name of drug (Company) Current clinical research phase
Direct sarcomere activators Directly activates myosin Omecamtiv mercarbil (Cytokinetics) Phase 3
Direct sarcomere activators Directly activates myosin MYK-491 (MyoKardia, Inc.) Phase 1b/2a
Phosphodiesterase inhibitors Inhibits PDE9, augments cGMP CRD-733 (Cardurion Pharmaceuticals) Phase 1
Phosphodiesterase inhibitors Inhibits PDE1, augments cGMP and cAMP ITI-214 (Intracellular Therapies, Inc.) Phase 1b/2a
Nitroxyl donors Antioxidant, enhances calcium sensitivity and calcium handling, augments NO signaling BMS-986231 (Bristol-Myers Squibb) Phase 2b
Soluble guanylate cyclase stimulators Augments cGMP-PKG signaling Vericiguat (Bayer/Merck) Phase 3
Apelin Gαi activation and Inhibition of β-arrestin, ERK activation CLR325 (Novartis); AMG986 (Amgen) Phase 3; Phase 1
Anti-inflammatory agents Blocks inflammatory interleukin 1β Canakinumab (Novartis) Phase 3

HFrEF, Heart failure with reduced ejection fraction; PDE, phosphodiesterase; cGMP, cyclic guanosine monophosphate; cAMP, cyclic adenosine monophosphate; NO, nitric oxide; PKG, Protein Kinase G; ERK, extracellular signal-regulated kinase