guanylate cyclase Inhibitors
7 drugsAbout guanylate cyclase
Guanylate cyclase (GC) catalyzes cyclic GMP (cGMP) production, a second messenger involved in various physiological processes. It plays a significant role in vasodilation, platelet aggregation, and other cellular functions.
Human genetic studies provide strong validation for targeting guanylate cyclase, with variants in GUCY1A1 linked to coronary artery disease (score 0.85) and Moyamoya disease (score 0.83). Gain-of-function variants are protective against coronary artery disease, suggesting activation may be beneficial.
Guanylate cyclase is targeted by 7 FDA-approved small molecule drugs, including NITROGLYCERIN, ADEMPAS and GENOSYL. These drugs are primarily used in cardiovascular indications, with some applications in other therapeutic areas.
Strategic Insights
ℹ️ How we calculate- White space opportunity in Chronic Obstructive Pulmonary Disease with only 2 trials.
- phase2 represents biological uncertainty with 53% completion.
Human Genetic Evidence Strong
Strong genetic evidence supports guanylate cyclase as a drug target, with a max genetic score of 0.85.
The strong genetic support suggests a higher probability of clinical success for guanylate cyclase-targeting drugs.
💡 Why activation?
- • Loss-of-function variants increase disease risk (OR > 1) — restoring function may help
- • 50% directional consistency across 2 traits
- • Strong signal in cardiovascular disease, gastrointestinal disease, nervous system disease pathways
Cross-Disease Effects
Trade-off: ModerateDirection of Effect
50% alignedEvidence Across Diseases
20 totalGWAS and other genetic studies link GUCY1A1 to 26 diseases.
Activating this target may be therapeutic
Loss-of-function causes disease; activation may help
🔗 Colocalization Evidence 20 strong
max H4: 1.00eQTL/pQTL signals for GUCY1A1 colocalize with these GWAS traits, providing causal evidence that gene expression changes drive disease risk.
Understanding these scores
Association Score (0-1): Combines all evidence types (genetic, literature, drugs, animal models). Higher = more evidence linking target to disease. This is a ranking heuristic, not a confidence score.
L2G Score: Open Targets uses a machine learning model (Locus-to-Gene) to predict which gene is causal at each GWAS locus. L2G=0.5 means ~50% probability of being the causal gene. Only associations with L2G > 0.05 are included.
Odds Ratio (OR): From gene burden studies (UK Biobank, AstraZeneca PheWAS). Measures how loss-of-function variants affect disease risk. OR<1 = protective (inhibiting target may help), OR>1 = risk (losing function causes disease).
Beta (β): Effect size for continuous traits. β<0 = protective, β>0 = risk.
Clinical Translation (~1.8x): Based on Nelson et al. 2015: drug targets with genetic evidence have ~2x higher success rates in clinical trials. We estimate: Strong support (score ≥0.7) → ~1.8x, Moderate (0.3-0.7) → ~1.3x, Weak → baseline.
Colocalization (H4): Tests whether a GWAS signal and an eQTL/pQTL signal share the same causal variant. H4 is the posterior probability that both traits are associated AND share a causal variant. H4 > 0.8 = strong evidence that gene expression/protein levels drive disease risk. This links genetic variation → gene expression → disease, supporting the target-disease connection.
Top Drugs
Seven companies have approved drugs targeting guanylate cyclase, including RUBICON RESEARCH and Bayer.
The relatively low number of companies suggests moderate barriers to entry in this market.
| Drug | Company | Approved | Indications |
|---|---|---|---|
| ADEMPAS | Bayer | 2013 | 2 |
| INOMAX | MALLINCKRODT IRELAND | 1999 | 2 |
| GENOSYL | VERO BIOTECH INC | 2019 | 2 |
| RECTIV | AbbVie | 2011 | 1 |
Drug Modality Landscape
Modalities
Routes of Administration
guanylate cyclase is amenable to small molecule drugs, with oral options available for convenient dosing.
Exploring alternative modalities like biologics could offer a competitive advantage in this space.
Clinical Trials 229 trials
Completion by Phase
| Phase | Total | Completed | Failed | Active | Completion |
|---|---|---|---|---|---|
| Phase 1 | 57 | 44 | 5 | 8 | 90% |
| Phase 2 | 93 | 55 | 31 | 5 | 64% |
| Phase 3 | 38 | 22 | 8 | 8 | 73% |
| Phase 4 | 41 | 27 | 6 | 7 | 82% |
Top Sponsors
By Modality
Top Conditions
Drug Approval Timeline (1981 - 2019)
The first drug was approved in 1981, and the most recent in 2019, spanning 39 years.
The approval timeline indicates a mature market, but opportunities may exist for novel therapies.
Pro Intelligence Preview
Deep insights for drug target analysis
Competitive Landscape
- • 7 companies competing
- • Market share by company
Full Drug Portfolio
- • All 7 approved drugs
- • Approval dates & indications
Genetic Validation
- • Full genetic evidence table
- • Effect sizes & directions
Approval Timeline
- • Full 7-drug timeline
- • First-of-modality markers
Clinical Trials Analysis
- • Competition: High (15 sponsors)
- • White space: 10 underexplored indications
- • Success rates by condition
Full summary • All drugs • Genetic evidence • Trials • Timeline
How We Calculate These Metrics
Target Attractiveness Score
A 0-100 score based on trial activity, sponsor diversity, and completion rates. Calculated from 136 clinical trials targeting guanylate cyclase.
Completion rate: Percentage of trials that reached their planned endpoint. Trials terminated early, withdrawn, or suspended are not counted—these often indicate safety issues, lack of efficacy, or strategic pivots.
- Highly Attractive (80+): High trial activity, many sponsors, strong completion rates
- Attractive (60-79): Good trial activity and validation
- Moderate (40-59): Moderate interest from sponsors
- Low (under 40): Limited trial activity or validation concerns
Strategic Insights
Auto-generated insights based on trial analytics including competition intensity, white space opportunities, modality shifts, and failure patterns. We analyze trial sponsors, phases, indications, and outcomes.
Risk Signals
- High Competition: Many sponsors competing for this target (may reduce market opportunity)
- High Failure Risk: Low trial completion rates suggest development challenges
- Low Validation: Limited trial activity or poor outcomes indicate uncertain viability
- White Space Available: Underexplored indications present opportunities