Aficamten vs Metoprolol for Obstructive Hypertrophic Cardiomyopathy: MAPLE-HCM Rationale, Study Design,...

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Standard-of-care (SOC) for symptomatic obstructive hypertrophic cardiomyopathy (oHCM) includes beta-blockers and nondihydropyridine calcium-channel blockers, which do not address the disease's core mechanism.
• Cardiac myosin inhibitors target the underlying pathophysiology by reducing actin-myosin binding, improving exercise capacity and symptoms in oHCM when added to SOC.

Purpose of the Study:

• To evaluate aficamten, a cardiac myosin inhibitor, as both first-line therapy and a monotherapy alternative to SOC drugs in patients with symptomatic oHCM.
• To address the evidence gap regarding the direct comparison of cardiac myosin inhibitors versus SOC medications in oHCM treatment.

Main Methods:

• The MAPLE-HCM study is a Phase 3 clinical trial comparing aficamten to metoprolol succinate in adults with symptomatic oHCM.
• The trial investigates aficamten's efficacy and safety as a first-line treatment and as a monotherapy for patients on current SOC drugs.

Main Results:

• This abstract describes the rationale, design, and baseline characteristics of patients enrolled in the MAPLE-HCM study.
• Specific efficacy and safety results are not yet available as the study is ongoing.

Conclusions:

• The MAPLE-HCM trial is designed to provide crucial head-to-head data comparing a cardiac myosin inhibitor (aficamten) with standard-of-care (metoprolol) for oHCM.
• Findings will inform treatment strategies for oHCM, potentially establishing aficamten as a first-line or monotherapy option.