Using Cardiac Myosin Inhibitors for the Treatment of oHCM

Opinion
Video

Dr James L. Januzzi reviews the use of cardiac myosin inhibitors for the management of oHCM.

This is a video synopsis of a discussion involving James L. Januzzi, MD, focusing on the development of cardiac myosin inhibitors and other therapies for the treatment of hypertrophic cardiomyopathy (HCM). Currently, the spotlight is on two cardiac myosin inhibitors: mavacamten (MYK-461) and aficamten. Mavacamten, the first approved cardiac myosin inhibitor for obstructive HCM, boasts a longer half-life of six to nine days, requiring time to interpret dose changes. However, it interacts with drugs inhibiting cytochrome P450 2C19 and 3A4 pathways, potentially increasing its concentrations when co-administered with common medications like omeprazole and certain antibiotics.

On the horizon is aficamten, with a shorter half-life of approximately three days, making dose adjustments more rapidly discernible compared to mavacamten. Notably, aficamten currently appears to have no issues with drug interactions via the P450 system, widening its therapeutic window. The advent of aficamten presents an additional therapeutic option for patients with HCM, offering benefits such as a shorter half-life and reduced susceptibility to drug interactions.

Understanding the benefits and risks of these medications is crucial for effective treatment. While cardiac myosin inhibitors hold promise for managing HCM, careful consideration of pharmacology and potential drug interactions is essential for optimizing patient outcomes. With both mavacamten and aficamten in the treatment arsenal, clinicians have more options to tailor therapies to individual patient needs, ultimately improving the management of HCM.

Video synopsis is AI-generated and reviewed by HCPLive® editorial staff.

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