2026-04-29T04:52:24Zhttps://repisalud.isciii.es/rest/oai/request
oai:repisalud.isciii.es:20.500.12105/268322025-12-18T12:57:27Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605
Repisalud author Davis, Bryton J author Volk, Hailey author Nguyen, Olives author Kamna, Daniel author Chen, Hongya author Barriales-Villa, Roberto author Garcia-Pavia, Pablo author Olivotto, Iacopo author Owens, Anjali T author Coats, Caroline J author Abraham, Theodore P author Solomon, Scott D author Maron, Martin S author Masri, Ahmad 2025-07-16T14:31:12Z 2025-07-16T14:31:12Z 2025-03-18 J Am Heart Assoc. 2025 Mar 18;14(6):e038758. https://hdl.handle.net/20.500.12105/26832 40055855 Journal of the American Heart Association Cardiac myosin inhibitors were recently developed to address the underlying pathophysiology of hypertrophic cardiomyopathy and to improve symptoms and quality of life. In this review, we evaluated the pharmacologic profile and clinical outcomes for mavacamten and aficamten, 2 cardiac myosin inhibitors investigated in symptomatic hypertrophic cardiomyopathy. Using a systematic search, 10 clinical trials with safety and efficacy data for either drug in obstructive hypertrophic cardiomyopathy (oHCM) and nonobstructive hypertrophic cardiomyopathy were included. Additionally, we included data from regulatory agencies. Both drugs demonstrated substantial benefit in reducing left ventricular outflow tract obstruction (Valsalva left ventricular outflow tract gradients improved by -45 mm Hg or better), symptom burden (placebo-corrected New York Heart Association class improvement ≥1 of at least 30%), and cardiac biomarkers (geometric mean ratio of 0.2 for N-terminal pro-B-type natriuretic peptide) while improving exercise parameters (improved placebo-corrected peak oxygen consumption of at least 1.4 to 1.8 mL/kg per minute) in patients with oHCM. Both drugs were generally well-tolerated, although patients on mavacamten had higher rates of treatment interruption (partly protocol-driven, 8.7% versus 0.5%, respectively, in oHCM) due to left ventricular ejection fraction reduction, atrial fibrillation (11.5 versus 4.1 per 100 patient-years, respectively, in oHCM), and heart failure (1.7 versus 0.0 per 100 patient-years, respectively, in oHCM) compared with aficamten. These comparisons are limited by a shorter exposure duration to aficamten, and longer follow-up is needed. The data in nonobstructive hypertrophic cardiomyopathy are derived from phase II trials, with phase III trials ongoing. Mavacamten and aficamten represent effective medications for the treatment of symptomatic oHCM. eng aficamten cardiac myosin inhibitors mavacamten symptomatic hypertrophic cardiomyopathy Safety and Efficacy of Mavacamten and Aficamten in Patients With Hypertrophic Cardiomyopathy. research article QWNlcHRhbmRvIGVzdGEgbGljZW5jaWEsIFVzdGVkIChlbCBhdXRvci9lcyBvIGVsIHByb3BpZXRhcmlvL3MgZGUgbG9zIGRlcmVjaG9zIGRlIGF1dG9yKSBjb25jZWRlIGEgUkVQSVNBTFVEIGVsIGRlcmVjaG8gbm8gZXhjbHVzaXZvIGRlIHJlcHJvZHVjaXIsIGNvbnZlcnRpciwgeS9vIGRpc3RyaWJ1aXIgc3UgZG9jdW1lbnRvIChpbmNsdXllbmRvIHN1IHJlc3VtZW4pIGEgbml2ZWwgbXVuZGlhbCBlbiBmb3JtYXRvIGRpZ2l0YWwsIGluY2x1eWVuZG8sIGF1ZGlvIHkgdsOtZGVvLCBhIHRyYXbDqXMgZGUgc3UgcmVwb3NpdG9yaW8gaW5zdGl0dWNpb25hbC4KClVzdGVkIGFjZXB0YSBxdWUgUkVQSVNBTFVEIHB1ZWRlLCBzaW4gYWx0ZXJhciBzdSBjb250ZW5pZG8sIGNvbnZlcnRpciBzdSBkb2N1bWVudG8gYSBjdWFscXVpZXIgb3RybyBmb3JtYXRvIGRpZ2l0YWwgZGUgZGF0b3MsIGF1ZGlvIHkgdmlkZW8sIGNvbiBlbCBwcm9ww7NzaXRvIGRlIHF1ZSBwdWVkYSBzZXIgYWxvamFkbyBlbiBlbCByZXBvc2l0b3Jpby4KClVzdGVkIGVzdMOhIGRlIGFjdWVyZG8gY29uIHF1ZSBSRVBJU0FMVUQgcHVlZGEgY29uc2VydmFyIG3DoXMgZGUgdW5hIGNvcGlhIGRlIGVzdGUgZG9jdW1lbnRvIHBhcmEgYXNlZ3VyYXIgc3Ugc2VndXJpZGFkLCBwcmVzZXJ2YWNpw7NuIHkgYWNjZXNvLgoKVXN0ZWQgZGVjbGFyYSBxdWUgZWwgZG9jdW1lbnRvIGVzIHVuIHRyYWJham8gb3JpZ2luYWwsIHkgcXVlIHRpZW5lIGVsIGRlcmVjaG8gZGUgb3RvcmdhciBsb3MgZGVyZWNob3MgY29udGVuaWRvcyBlbiBlc3RhIGxpY2VuY2lhLiBUYW1iacOpbiBkZWNsYXJhIHF1ZSBzdSBwZXRpY2nDs24gbm8gaW5mcmluZ2UgbG9zIGRlcmVjaG9zIGRlIGF1dG9yIGRlIG5hZGllLgoKU2kgZWwgZG9jdW1lbnRvIGNvbnRpZW5lIG1hdGVyaWFsZXMgcGFyYSBsb3MgcXVlIG5vIHNlIHRpZW5lbiBsb3MgZGVyZWNob3MgZGUgYXV0b3IsIHVzdGVkIGRlY2xhcmEgcXVlIGhhIG9idGVuaWRvIGVsIHBlcm1pc28gc2luIHJlc3RyaWNjacOzbiBkZWwgcHJvcGlldGFyaW8gZGUgbG9zIGRlcmVjaG9zIHkgcXVlIGVuIGRpY2hvIG1hdGVyaWFsLCBlc3TDoSBjbGFyYW1lbnRlIGlkZW50aWZpY2FkYSB5IHJlY29ub2NpZGEgc3UgYXV0b3LDrWEgZGVudHJvIGVsIHRleHRvIG8gZGVsIGNvbnRlbmlkbyBkZSBkaWNobyBkb2N1bWVudG8uCgpTaSBlbCBlbnbDrW8gc2UgYmFzYSBlbiB1biB0cmFiYWpvIHF1ZSBoYSBzaWRvIHBhdHJvY2luYWRvIG8gYXBveWFkbyBwb3IgdW5hIGFnZW5jaWEgdSBvcmdhbml6YWNpw7NuIGRpc3RpbnRhIGEgUkVQSVNBTFVELCB1c3RlZCBhY2VwdGEgcXVlIGhhIGN1bXBsaWRvIGNvbiBlbCBkZXJlY2hvIGRlIHJldmlzacOzbiB5IG90cmFzIG9ibGlnYWNpb25lcyByZXF1ZXJpZGFzIHBvciBjb250cmF0byBvIGFjdWVyZG8uCgpSRVBJU0FMVUQgaWRlbnRpZmljYXLDoSBjbGFyYW1lbnRlIHN1KHMpIG5vbWJyZShzKSBjb21vIGF1dG9yKHMpIG8gcHJvcGlldGFyaW8ocykgZGVsIGRvY3VtZW50bywgeSBubyBoYXLDoSBuaW5ndW5hIGFsdGVyYWNpw7NuLCBleGNlcHRvIHNlZ8O6biBsbyBwZXJtaXRpZG8gcG9yIGVzdGEgbGljZW5jaWEuCg== URL https://repisalud.isciii.es/bitstreams/7b330c61-a27b-41dc-8a50-f3e38010a898/download File MD5 6060ad79963c428c65a0a3dfa62c65e3 678927 application/pdf Safety and Efficacy of Mavacamten and Aficamten_J Am Heart Assoc_2025.pdf