MAVACAMTEN, A NOVEL DRUG FOR HYPERTROPHIC CARDIOMYOPATHY: REVIEW

Introduction: Hypertrophic cardiomyopathy (HCM) is a common known monogenetic cardiovascular disorder which leads to dyspnea and exercise tolerance.Recent guidelines have different therapies.Hence, mavacamten is a small molecule modulator of beta cardiac myosin reduces hypercontractability which is the central mechanism of HCM.Hence, it is evaluated in phase 2 and 3 clinical trials for obstructive and non obstructive symptomatic HCM.Purpose of Review: The pharmacological treatment for hypertrophic cardiomyopathy are limited and includes therapies such as beta blockers, non-dihydropyridine calcium channel blockers and disopyramide.They offer variable degree of symptomatic relief, suboptimal and are limited by side effects which addresses to molecular abnormalities of the disease.Recent Finding: Mavacamten is novel, allosteric inhibitor of cardiac myosin ATPase, which reduces actin-myosin cross bridge formation thus may reduce contractability and improves myocardial energy consumption.The phase 2 and phase 3 demonstrates the efficacy and safety in reducing left ventricular outflow tract obstruction and exercise capacity in oHCM patients.Summary: Mavacamten represent the first agent for HCM which is registered for clinical use, representing a change in paradigm in the pharmacological treatment of HCM.It is effective in obstructive HCM and non obstructive HCM.