Abstract
Background
Olfactory dysfunction affects approximately 29% of the population and has a profound impact on quality of life. It frequently follows upper respiratory tract infections and lacks effective pharmacological treatments. Vericiguat, a soluble guanylate cyclase stimulator that increases intracellular cyclic guanosine monophosphate, is approved for heart failure and has potential neuro-modulatory effects relevant to olfactory processing.
Objective
This pilot study investigates the efficacy of oral vericiguat in improving olfactory function in patients with persistent anosmia following upper respiratory tract infections.
Methods
In a double-blind, randomized controlled trial, 88 participants with post-infectious anosmia were assigned to receive either placebo (n = 44) or vericiguat (4 mg, twice daily; n = 44) for 12 months. Olfactory function was assessed monthly using the Sniffin’ Sticks test, measuring Threshold (T), Discrimination (D), and Identification (I) scores. Data were analyzed using repeated-measures ANOVA and post-hoc Bonferroni corrections.
Results
At baseline, all olfactory scores were similar between groups. In the vericiguat group, T scores increased from 3.84 ± 0.19 to 4.65 ± 0.20 (P = 0.003), D scores from 8.25 ± 0.65 to 9.20 ± 0.86 (P = 0.008), and I scores from 7.34 ± 0.72 to 8.62 ± 0.79 (P = 0.008). No significant changes were observed in the placebo group. Between-group differences became statistically significant for D at month 4 (P < 0.05), T at month 6 (P < 0.05), and I at month 7 (P < 0.05). However, the mean total TDI improvement in the vericiguat group (+ 3.19) did not reach the clinical threshold of 5.5 points.
Conclusion
Vericiguat significantly improved olfactory threshold, discrimination, and identification scores compared to placebo. These findings highlight its potential as a pharmacological option for olfactory dysfunction, although the clinical magnitude of benefit remains below the established threshold. Further studies should explore mechanisms and broader clinical applications.
Trial registration
DFM-IRB00012367–23-07-008.
Keywords
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References
Supplementary Material
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