Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy

Desai, Milind Y. and Owens, Anjali T. and Abraham, Theodore and Olivotto, Iacopo and Garcia-Pavia, Pablo and Lopes, Renato D. and Elliott, Perry and Fernandes, Fabio and Verheyen, Nicolas and Maier, Lars S. and Meder, Benjamin and Azevedo, Olga and Kitaoka, Hiroaki and Wolski, Kathy and Wang, Qiuqing and Jaber, Wael and Mitchell, Lisa and Myers, Jonathan and Rano, Thomas and Gong, Zhiqun and Zhong, Yue and Carter-Bonanza, Suzanne and Florea, Victoria and Aronson, Ron and Nissen, Steven E. (2025) Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy. NEW ENGLAND JOURNAL OF MEDICINE, 393 (10). pp. 961-972. ISSN 0028-4793, 1533-4406

Full text not available from this repository. (Request a copy)

Abstract

Background Mavacamten is approved to treat adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM). However, its effects in nonobstructive HCM remain uncertain.Methods We conducted a phase 3, international, double-blind, placebo-controlled, clinical trial to determine whether mavacamten improves functional capacity and patient-reported health status among adults with symptomatic nonobstructive HCM. Patients were randomly assigned in a 1:1 ratio to receive mavacamten (starting at 5 mg per day and adjusted up to a maximum of 15 mg per day on the basis of left ventricular ejection fraction) or placebo (with sham dose adjustment) for 48 weeks. The two primary end points were the change from baseline to week 48 in peak oxygen uptake and in the 23-item Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range from 0 to 100, with higher scores indicating better health status).Results We randomly assigned 289 patients to receive mavacamten and 291 to receive placebo. The mean (+/- SD) age of the patients was 56 +/- 15 years, and 46% were women. From baseline to week 48, the least-squares mean change in peak oxygen uptake was 0.52 ml per kilogram of body weight per minute (95% confidence interval [CI], 0.09 to 0.95) in the mavacamten group and 0.05 ml per kilogram per minute (95% CI, -0.38 to 0.47) in the placebo group (between-group difference, 0.47 ml per kilogram per minute; 95% CI, -0.03 to 0.98; P=0.07). The least-squares mean change in the KCCQ-CSS was 13.1 points (95% CI, 10.7 to 15.5) in the mavacamten group and 10.4 points (95% CI, 8.0 to 12.8) in the placebo group (between-group difference, 2.7 points; 95% CI, -0.1 to 5.6; P=0.06). Reductions in ejection fraction and interruptions in the trial regimen were more common with mavacamten than with placebo.Conclusions Among patients with nonobstructive HCM, mavacamten did not result in a significantly greater improvement in peak oxygen uptake or decrease in symptoms than placebo. (Funded by Bristol Myers Squibb; ODYSSEY-HCM ClinicalTrials.gov number, NCT05582395.) In patients with nonobstructive HCM, mavacamten did not significantly improve peak oxygen uptake or decrease symptoms as compared with placebo, and more patients had a reduction in LVEF with mavacamten.

Item Type: Article
Uncontrolled Keywords: ;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 31 Mar 2026 09:35
Last Modified: 31 Mar 2026 09:35
URI: https://pred.uni-regensburg.de/id/eprint/67834

Actions (login required)

View Item View Item