Aficamten vs Metoprolol for Obstructive Hypertrophic Cardiomyopathy
Beta-blockers and nondihydropyridine calcium-channel blockers have been standard-of-care (SOC) medications for patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), even though these agents do not directly affect the underlying pathophysiology of the disease. Cardiac myosin inhibitors act by decreasing the number of myosin heads binding to actin, reducing the pathologic hypercontractility of HCM, and have been shown to improve exercise capacity and alleviate symptoms in oHCM when added to SOC medications. Cardiac myosin inhibitors are currently considered as second-line therapy in the absence of head-to-head comparison studies vs SOC medications. The aim of the ongoing phase 3 study MAPLE-HCM (Metoprolol vs Aficamten in Patients With LVOT Obstruction on Exercise Capacity in HCM) is to fill this evidence gap by evaluating aficamten as both first-line therapy for newly diagnosed oHCM and as a monotherapy alternative for patients currently on SOC drugs. The authors describe the rationale, design, and baseline characteristics of patients in this study. (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Metoprolol Succinate in Adults With Symptomatic oHCM [MAPLE-HCM]; NCT05767346).
Authors
- Perry Elliott (ORCID: https://orcid.org/0000-0003-3383-3984)
- Stephen B. Heitner (ORCID: https://orcid.org/0000-0003-2189-1474)
- P. Christian Schulze
- Ajith Nair (ORCID: https://orcid.org/0000-0002-3755-4985)
- Amy Wohltman
- Ozlem Bilen (ORCID: https://orcid.org/0000-0002-3078-5262)
- Melissa Burroughs
- Steen Hvitfeldt Poulsen (ORCID: https://orcid.org/0000-0002-9586-835X)
- Anne M. Dybro (ORCID: https://orcid.org/0000-0003-3175-9725)
- Andrew Z. Wang (ORCID: https://orcid.org/0000-0002-9781-4494)
- Regina Sohn
- Juan Pablo Costabel (ORCID: https://orcid.org/0000-0003-0073-5739)
- Neal K. Lakdawala (ORCID: https://orcid.org/0000-0001-6458-5421)
- Edileide de Barros Correia (ORCID: https://orcid.org/0000-0001-6414-8838)
- Pablo García‐Pavía (ORCID: https://orcid.org/0000-0002-5470-2257)
- Daniel Jacoby (ORCID: https://orcid.org/0000-0002-9182-275X)
- Fady I. Malik (ORCID: https://orcid.org/0000-0002-5597-5759)
- Stuart Kupfer (ORCID: https://orcid.org/0000-0002-5469-1287)
- Michael A. Fifer (ORCID: https://orcid.org/0000-0002-8363-445X)
- Indrias Berhane
- Lisa Meng (ORCID: https://orcid.org/0000-0003-0229-1131)
- Michael E. Nassif (ORCID: https://orcid.org/0000-0002-1232-7604)
- Amy Mann
- Patricia Réant (ORCID: https://orcid.org/0000-0003-4897-1036)
Institutions
- Brigham and Women's Hospital (US)
- WellStar Health System (US)
- Saint Luke's Health System (US)
- Emory University (US)
- Université de Bordeaux (FR)
- Baylor College of Medicine (US)
- Aarhus University Hospital (DK)
- University Medical Center (US)
- British Heart Foundation (GB)
- Massachusetts General Hospital (US)
- Hospital Universitario Puerta de Hierro Majadahonda (ES)
- Bordeaux Population Health (FR)
- Duke Medical Center (US)
- Saint Luke's Hospital (US)
- Cytokinetics (United States) (US)
- Instituto Dante Pazzanese de Cardiologia (BR)
- Instituto Cardiovascular de Buenos Aires (AR)
- University College London (GB)
- Friedrich Schiller University Jena (DE)
Publication Details
- Journal
- JACC Heart Failure
- Published
- 2025-02-01
- DOI
- https://doi.org/10.1016/j.jchf.2024.11.011
- Citations
- 18
- Primary Topic
- Cardiomyopathy and Myosin Studies
- Type
- article
- Field-Weighted Citation Impact
- 24.99
Funders
- Cytokinetics