Omecamtiv Shows Early Promise for Heart Failure

It seems intuitive that agents that improve cardiac contractility would help patients with systolic dysfunction. Unfortunately, existing agents — including dobutamine (an adrenergic stimulant), milrinone (a phosphodiesterase inhibitor), and levosimendan (a calcium sensitizer unavailable in the U.S.) — are associated with morbidity and mortality that outweigh their benefits. Two manufacturer-sponsored studies now provide early insights into the possible use of omecamtiv mecarbil, a novel selective cardiac myosin activator that, in animal models, increases cardiac contractility without increasing intracellular calcium.

In a phase I study, 34 healthy volunteers received a 6-hour, double-blind, intravenous infusion of omecamtiv or placebo once w…