Hi Gal,
It looks like SAS is still the most popular tool for SDTM conversion.
There are many ETL (Extract Transfer Load) software designed for this work as well. The major problem is that they can help with simple part, while complicated transformations require manual programming. A simple part can be also easy done in SAS. Price and a need for new specialized skills are another obstacles to broad adoption of ETL tools by the industry.
Based on my experience, today most companies use SAS. Standardization of data collection process allows to re-use programs and develop SDTM mapping macro library.
~5 years ago I looked at CDISC Express which is (was?) an example of typical macro library which any experienced programmer would create for himself. A problem with CDISC Express was its very limited license which did not allow to do anything except software evaluation and providing feedback to developers. It looked as a marketing project to sell the company service for SDTM conversion. It may be some changes over 5 years.
Kind Regards,
Sergiy