Aficamten in Patients With Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy (Redwood-HCM Cohort 4)

Monitoring treatment with cardiac myosin inhibitors in symptomatic obstructive hypertrophic cardiomyopathy

“…Although patients with nonobstructive HCM may experience similarly poor outcomes as those with obstructive physiology, treatment options are considerably more limited and represent a key area of future study [24]. Phase 2 studies of both mavacamten [25] and aficamten [26] have been promising and support phase 3 studies for this subtype of HCM.…”

“…Although patients with nonobstructive HCM may experience similarly poor outcomes as those with obstructive physiology, treatment options are considerably more limited and represent a key area of future study [24]. Phase 2 studies of both mavacamten [25] and aficamten [26] have been promising and support phase 3 studies for this subtype of HCM. The favourable impact of CMIs on symptoms and biomarkers in patients with nonobstructive HCM has raised interest in mavacamten as a potential therapeutic option in patients with heart failure with preserved ejection fraction (HFpEF) [26].…”

“…The favourable impact of CMIs on symptoms and biomarkers in patients with nonobstructive HCM has raised interest in mavacamten as a potential therapeutic option in patients with heart failure with preserved ejection fraction (HFpEF) [26]. Although the clinical benefits of most heart failure therapies extend to patients with mildly reduced ejection fraction, there is a relative paucity of treatment options for patients with preserved and supranormal ejection fraction.…”

“…Although the clinical benefits of most heart failure therapies extend to patients with mildly reduced ejection fraction, there is a relative paucity of treatment options for patients with preserved and supranormal ejection fraction. Cardiac myosin inhibitors exert their action in part by improving diastolic function and reducing myocardial hypercontractility and may therefore have beneficial effects in the treatment of patients with HFpEF [26]. This is an important area of future study and is the subject of an ongoing phase 2a proof-of-concept trial assessing the influence of treatment with mavacamten on NT-proBNP levels in patients with HFpEF [27].…”

State‐of‐the‐art document on optimal contemporary management of cardiomyopathies

“…This agent has also shown promising results for functional and symptomatic improvement in a recent phase 2 trial of patients with non-obstructive HCM (REDWOOD-HCM, NCT04219826). 229 New strategies of management of ATTR amyloidosis focus on degradation/removal of amyloid fibrils, 230 and anti-seeding therapies (i.e. prevention of the formation of 'amyloid seeds' defined as small fibril fragments that induce aggregation, spread and deposition of amyloid fibrils).…”