Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: An Interaction Study to Evaluate Changes in Blood Pressure Following 1, 1.5, 2, and 2.5 mg Riociguat Tid (Dose Titration) Compared to Placebo Treatment on the Background of Stable Sildenafil Pretreatment in Subjects With Symptomatic Pulmonary Arterial Hypertension
Brief Summary: Pulmonary Arterial Hypertension (PAH) is a severe progressive disease with a high mortality. Although several drugs are available for the treatment of PAH none offer a cure, therefore there is still a high medical need for new treatments.

Soluble guanylate cyclase (sGC) is one of the chemicals involved in the pathways controlling vascular tone, which is impaired in patients with PAH. This causes constriction and thickening of the blood vessels wall in the lungs and increase of blood pressure in the lungs. This can lead to the very debilitating symptoms of PAH such as tiredness, shortness of breath on exertion, collapse and often the inability of the patient to perform their daily life activities.

Inhalation of Nitric Oxide, which activates sGC is used to treat PAH, but its effect wears off as soon as inhalation stops. Direct stimulation of sGC using this new compound Riociguat may be a new approach for the treatment of PAH.

The phosphodiesterase 5 (PDE5)-inhibitor Sildenafil is one of licensed treatments for PAH. The Patent Plus is a double-blind, placebo-controlled safety study, designed to investigate the effect of Riociguat on blood pressure in patients with PAH when given in combination with Sildenafil.


Options:
A: Arm Label: Riociguat (Adempas, BAY63-2521)_individual dose titration; Type: EXPERIMENTAL; Interventions: Drug: Riociguat (Adempas, BAY63-2521) | Arm Label: Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo | Intervention Type: DRUG; Name: Riociguat (Adempas, BAY63-2521); Assigned to Arm(s): Riociguat (Adempas, BAY63-2521)_individual dose titration | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Placebo
B: Arm Label: 20 mg tadalafil; Type: ACTIVE_COMPARATOR; Interventions: Drug: tadalafil | Arm Label: 40 mg tadalafil; Type: ACTIVE_COMPARATOR; Interventions: Drug: tadalafil | Intervention Type: DRUG; Name: tadalafil; Assigned to Arm(s): 20 mg tadalafil | Intervention Type: DRUG; Name: tadalafil; Assigned to Arm(s): 40 mg tadalafil
C: Arm Label: Riociguat (Adempas, BAY63-2521) up to 2.5 mg_IDT; Type: EXPERIMENTAL; Interventions: Drug: Riociguat (Adempas, BAY63-2521), Drug: Sildenafil | Arm Label: Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo, Drug: Sildenafil | Intervention Type: DRUG; Name: Riociguat (Adempas, BAY63-2521); Assigned to Arm(s): Riociguat (Adempas, BAY63-2521) up to 2.5 mg_IDT | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Placebo | Intervention Type: DRUG; Name: Sildenafil; Assigned to Arm(s): Placebo, Riociguat (Adempas, BAY63-2521) up to 2.5 mg_IDT
D: Arm Label: Sildenafil plus pulmonary rehabilitation; Type: EXPERIMENTAL; Interventions: Drug: Sildenafil | Arm Label: Placebo plus pulmonary rehabilitation; Type: PLACEBO_COMPARATOR; Interventions: Other: Placebo | Intervention Type: DRUG; Name: Sildenafil; Assigned to Arm(s): Sildenafil plus pulmonary rehabilitation | Intervention Type: OTHER; Name: Placebo; Assigned to Arm(s): Placebo plus pulmonary rehabilitation

Answer: C