Efficacy and Safety of Omecamtiv Mecarbil in Adult Patients with Heart Failure with Reduced Ejection Fraction

Background and Objective: Irregular ventricular contraction is common in patients with heart failure. There is no promising treatment option available that effectively improves myocardial function by acting directly on the myocardium. The present study compares the efficacy and safety of omecamtiv mecarbil versus placebo in Chinese patients with reduced ejection fraction. Materials and Methods: Diabetes patients aged >18 years on treatment for heart failure-related symptoms and with ejection fraction of ≤35% (left ventricular) and natriuretic peptide levels of ≥400 pg/mL received oral omecamtiv mecarbil (25/37.5/50 mg, twice daily, the OM group) or placebo (100 patients in each group) for 48 weeks. Hospitalization, the change in KCCQ score, death due to heart failure and adverse events were evaluated and analyzed. Results: Patients of the OM group had greater clinical success as compared to placebo (cardiovascular events (death), hospitalization due to heart failure and urgent outpatient visits due to worsening heart failure (p<0.05 for all)). Compared to the placebo, the in-patients and the out-patients of the OM group had a significantly greater reduction in KCCQ total symptom from baseline at each subsequent post-treatment visit (p<0.05 for all). The most frequent adverse events are tachyarrhythmia, angina, stroke and QT prolongation across both groups. Adverse events leading to treatment discontinuation were also similar across both groups, with a slightly greater numbers who received placebo. Conclusion: Oral omecamtiv mecarbil could be a better alternative in the management of heart failure among Chinese patients with low ejective fraction.