SGCB and systemic sclerosis: In preclinical studies, avenciguat has shown in vivo modulation of vascular, autoimmune and fibrotic pathways, and may thus offer the potential to be a disease-modifying treatment addressing all three aspects of SSc pathophysiology (microvasculopathy, immune dysregulation and fibrosis).24 In microvascular endothelial cells, avenciguat reduced the production of the profibrotic cytokine TGF-β2 under hypoxic conditions, highlighting its potential advantages compared with sGC stimulators, such as riociguat, in environments of hypoxia and oxidative stress.24