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Avenciguat (BI 685509) is an orally administered, nitric oxide-independent activator of soluble guanylate cyclase (sGC) developed by Boehringer Ingelheim. It is a small molecule drug under investigation for the treatment of several conditions characterized by vascular dysfunction and fibrosis, including diabetic nephropathy (diabetic kidney disease), portal hypertension associated with liver cirrhosis, and systemic sclerosis. Avenciguat works by directly activating sGC even under conditions of oxidative stress where nitric oxide signaling is impaired, leading to increased production of cyclic GMP (cGMP). This mechanism helps restore vascular function and reduce fibrosis in affected organs. Preclinical studies have shown that avenciguat reduces organ fibrosis and improves outcomes in models of kidney disease and liver injury. Clinical trials are ongoing to assess its efficacy and safety in these indications[1][3][4][5][6].
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