Aficamten: A Breakthrough Therapy for Symptomatic Obstructive Hypertrophic Cardiomyopathy.

Publication Title

American journal of cardiovascular drugs : drugs, devices, and other interventions

Document Type

Article

Publication Date

9-1-2023

Keywords

washington; swedish; Humans; Cardiomyopathy, Hypertrophic; Calcium Channel Blockers; Adrenergic beta-Antagonists; Cardiac Myosins

Abstract

Aficamten is a novel cardiac myosin inhibitor that has demonstrated its ability to safely lower left ventricular outflow tract (LVOT) gradients and improve heart failure symptoms in patients with obstructive hypertrophic cardiomyopathy (HCM). Based on the REDWOOD-HCM open label extension (OLE) study, participants receiving aficamten had significantly reduced resting and Valsalva LVOT gradient within 2 weeks after initiating treatment, with ongoing improvements over 24 weeks, and recent evidence suggests effects can sustain up to 48 weeks. While beta-blockers, calcium channel blockers, and disopyramide have shown some benefits in managing HCM, they have limited direct impact on the underlying disease process in patients with obstructive HCM. Aficamten achieves its therapeutic effect by reducing hypercontractility and improving diastolic function in obstructive HCM. Mavacamten was the first cardiac myosin inhibitor approved for symptomatic obstructive HCM. However, aficamten has a shorter human half-life (t

Area of Special Interest

Cardiovascular (Heart)

Specialty/Research Institute

Cardiology

Specialty/Research Institute

Surgery

Specialty/Research Institute

Pharmacy

DOI

10.1007/s40256-023-00599-0

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