[Mavacamten (Camzyos ®) : first myosin modulator for obstructive hypertrophic cardiomyopathy treatment]

Area of Science:

• Cardiology
• Pharmacology
• Biochemistry

Context:

• Hypertrophic cardiomyopathy (HCM) involves overactive myosin-actin interactions, leading to impaired diastolic function and reduced exercise capacity.
• Obstructive HCM (oHCM) affects symptomatic adult patients (NYHA class II-III).
• Current treatments for oHCM have limitations, creating a need for innovative pharmacological options.

Purpose:

• To review the efficacy, safety, and guideline recommendations for mavacamten (Camzyos®) in treating symptomatic obstructive hypertrophic cardiomyopathy.
• To highlight mavacamten's mechanism of action as a cardiac myosin inhibitor.
• To discuss its role as a potential alternative to septal reduction therapy.

Summary:

• Mavacamten, a selective cardiac myosin inhibitor, reduces excessive myosin-actin binding in HCM, thereby decreasing hypercontractility and improving diastolic function.
• Clinical studies demonstrate mavacamten's ability to significantly reduce the intraventricular pressure gradient, enhance functional capacity, and alleviate symptoms in patients with oHCM.
• The drug is generally well-tolerated, with a known dose-dependent and reversible reduction in left ventricular ejection fraction requiring monitoring.

Impact:

• Mavacamten offers a new pharmacological approach for managing obstructive HCM, potentially improving patient quality of life and reducing the need for invasive procedures.
• Its inclusion in the latest European Society of Cardiology guidelines underscores its recognized clinical value.
• Long-term effectiveness and safety data suggest sustained benefits for patients with obstructive HCM.