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Effect of Mavacamten in Women Compared With Men With Obstructive Hypertrophic Cardiomyopathy: Insights From
Sharon Cresci1,2, Richard G Bach1, Sara Saberi3
1Cardiovascular Division, Department of Medicine, (S.C., R.G.B.), Washington University School of Medicine, St Louis, MO.
Circulation
|November 14, 2023
Summary
Women with hypertrophic cardiomyopathy (HCM) showed similar treatment responses to mavacamten compared to men, with greater improvements in health status and NT-proBNP levels. This suggests mavacamten is effective for both sexes in managing HCM symptoms.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Women with hypertrophic cardiomyopathy (HCM) experience higher heart failure incidence and worse outcomes than men.
- The EXPLORER-HCM study evaluated mavacamten in symptomatic obstructive HCM patients.
Purpose of the Study:
- To compare baseline characteristics and response to mavacamten between women and men with obstructive HCM.
- To assess the efficacy and safety of mavacamten in a sex-stratified analysis.
Main Methods:
- A post hoc analysis of sex from the randomized, placebo-controlled EXPLORER-HCM trial.
- Baseline characteristics were compared using t tests and chi-squared tests.
- Treatment outcomes at 30 weeks were analyzed using ANCOVA and generalized linear models.
Main Results:
- Baseline: Women were older, had lower peak oxygen consumption, worse health status, and higher NT-proBNP levels than men.
- Mavacamten treatment yielded similar improvements in primary and secondary endpoints for both sexes.
- Women demonstrated significantly greater improvements in health status (KCCT-CS) and NT-proBNP levels.
Conclusions:
- Despite older age and worse baseline status, women with obstructive HCM responded well to mavacamten.
- Mavacamten offers comparable efficacy to men regarding primary and secondary endpoints.
- Mavacamten provides superior benefits in health status and NT-proBNP reduction for women with HCM.
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