What question did this study set out to answer?

This study aims to compare the efficacy of mavacamten versus aficamten in patients with hypertrophic cardiomyopathy.

January 25, 2026Exploration of Cardiology0 citationsOpen Access

Is mavacamten superior to aficamten for hypertrophic cardiomyopathy? A frequentist network meta-analysis

Q: What does this research mean for the field?

Mavacamten causes a greater reduction in resting LVOT gradient than aficamten by 14.74 mmHg, indicating superior efficacy in patients with hypertrophic cardiomyopathy. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

AAAyesha AmanKing Edward Medical University BABisma AkramKing Edward Medical University AAArfa AkramFederal Urdu University

Resultado clave

Mavacamten caused a greater reduction in resting LVOT gradient than aficamten by 14.74 mmHg, indicating superior efficacy in patients with hypertrophic cardiomyopathy.

Puntos clave

This study aims to compare the efficacy of mavacamten versus aficamten in patients with hypertrophic cardiomyopathy.
Conducted a network meta-analysis using data from six randomized controlled trials.
Reviewed literature from various electronic databases until October 2024.
Applied a random-effects model to pool effect sizes such as mean difference and risk ratio.
Mavacamten led to a greater reduction in resting left ventricular outflow tract gradient compared to aficamten.
Mavacamten ranked higher in decreasing resting LVOT gradient based on P-scores.
No significant difference was observed between the two drugs for NYHA class improvement.

PICO estructurado

Does mavacamten improve resting LVOT gradient compared to aficamten in patients with hypertrophic cardiomyopathy?

Población

826 individuals with hypertrophic cardiomyopathy (HCM) from 6 RCTs (443 received cardiac myosin inhibitor, 383 received placebo). Mean age 59.8 in intervention vs 60.9 in placebo. Included both obstructive and non-obstructive HCM patients on background beta-blocker or calcium channel blocker therapy.

Intervención

Cardiac myosin inhibitors (mavacamten 2.5-15 mg oral daily or aficamten 5-30 mg oral daily) added to background HCM therapy for 10 to 30 weeks.

Comparador

Placebo added to background HCM therapy (used as a common comparator for indirect network meta-analysis).

Resultado

Change in resting left ventricular outflow tract (LVOT) gradientsurrogate

Indirect network meta-analysis suggests mavacamten may be superior to aficamten in reducing resting LVOT gradient and preserving LVEF in patients with hypertrophic cardiomyopathy, though direct head-to-head trials are needed.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Background: Myosin inhibitors have been shown to improve exercise capacity and symptoms, as well as reduce the left ventricular outflow tract (LVOT) gradient. This study explores the efficacy of mavacamten versus aficamten in hypertrophic cardiomyopathy (HCM) patients. Methods: From the inception to October 2024, the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and ClinicalTrials.gov were searched. Using a random-effects model and a frequentist framework, specific effect sizes mean difference (MD) and risk ratio (RR) were pooled. Results: This network meta-analysis included six randomized controlled trials (RCTs). A total of 826 individuals with HCM were included; 443 of them received a cardiac myosin inhibitor, while 383 received placebo. Comparison of aficamten versus mavacamten through a common comparator, placebo, showed that aficamten caused a lesser decrease in resting LVOT gradient than that of mavacamten MD = 14.74, 95% CI (3.02; 26.47). Therefore, mavacamten ranked higher (P-score = 0.9966) than aficamten (P-score = 0.5034) in decreasing resting LVOT gradient. Aficamten significantly reduced left ventricular ejection fraction (LVEF) in contrast to mavacamten MD = –5.59, 95% CI (–10.43; –0.75). According to P-score ranking, mavacamten (0.5053) ranked higher than aficamten (0.0059). For New York Heart Association (NYHA) class improvement, there was no statistically significant difference between the two groups MD = –0.37, 95% CI (–1.79; 1.06). But P-score ranked mavacamten (0.8466) higher than aficamten (0.6533). Discussion: Mavacamten ranked superior to aficamten in HCM management. However, this ranking is based not on the absolute clinical benefit but on the network point estimates. Additionally, due to a larger body of clinical evidence supporting mavacamten, it has a clear advantage in terms of reliability. Therefore, more direct trials comparing the two drugs would be required to confirm which one is better and provide conclusive evidence.

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Cite This Study

Aman et al. (Fri,) reported a other. Mavacamten caused a greater reduction in resting LVOT gradient than aficamten by 14.74 mmHg, indicating superior efficacy in patients with hypertrophic cardiomyopathy.

synapsesocial.com/papers/6975b1eafeba4585c2d6d5f4 https://doi.org/https://doi.org/10.37349/ec.2026.101289

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