A New Cardiac Myosin Inhibitor for Obstructive Hypertrophic Cardiomyopathy?

In a manufacturer-funded trial, aficamten improved exercise performance compared with placebo in patients with symptomatic obstructive HCM.

Cardiac myosin inhibitors represent an important recent advance in the evidence-based treatment of hypertrophic cardiomyopathy (HCM). One of these agents, mavacamten, has a class Ib practice guideline recommendation as adjunctive therapy in patients with symptomatic obstructive phenotype for whom beta-blockers or calcium-channel blockers do not relieve symptoms (NEJM JW Cardiol May 10 2024 and Circulation 2024 May 8; [e-pub]).

In this manufacturer-sponsored, phase 3, randomized trial (NCT05186818), investigators assessed the efficacy of the non–FDA-approved oral selective myosin inhibitor aficamten (initial dose, 5 mg; maximum, 20 mg) in 282 individuals with obstructive HCM and persistent symptoms despite background therapy, which was contin…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, 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)