A Potential New Drug Class for Heart Failure with Reduced Ejection Fraction

Omecamtiv mecarbil modestly improved outcomes in a placebo-controlled, randomized trial.

None of the evidence-based therapies that improve outcomes in patients who have heart failure with reduced ejection fraction (HFrEF) does so by bolstering cardiac performance. Omecamtiv mecarbil (not FDA-approved) is in a new class of drugs (“myotropes”) that enhance cardiac myosin's binding to actin. In a previous study of patients with HFrEF, omecamtiv improved cardiac performance, assessed with echocardiography and brain-type natriuretic peptide (BNP) levels.

Now, in a manufacturer-funded phase 3 trial (NCT02929329), 8256 patients with a left-ventricular EF ≤35% and elevated BNP levels were randomized to receive either placebo or omecamtiv mecarbil at one of three doses based upon plasma drug levels. Participants' mean age was 65, 21% wer…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)