Heart failure & cardiomyopathies
Concomitant Aficamten and Disopyramide in Symptomatic Obstructive Hypertrophic Cardiomyopathy
Authors' conclusion
In this cohort of patients with symptomatic oHCM with persistent LVOT obstruction, combination therapy with aficamten and disopyramide was safe and well tolerated but did not enhance clinical efficacy vs aficamten alone.
Study context
- Population
- Patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) despite background disopyramide50 unique patients
- Participants
- 93 patients
- Comparison
- Aficamten added to disopyramide, and withdrawal of either drug
- Diso-Afi Withdrawaln = 29
- Diso-Pbon = 20reference
- Afi-Diso Withdrawaln = 17
- Diso+Afi Continuousn = 27
- Outcome
- Effect of adding aficamten to disopyramide
Methodological detailsopen-label and placebo-controlled trials, mean disopyramide dose 331 ± 146 mg/d
- Open-label and placebo-controlled trials
- Mean disopyramide dose 331 ± 146 mg/d
Pooled result
As reported in the abstract
- Resting left ventricular outflow tract (LVOT) gradient, Δ least squares mean
- −27.0 ± 3.6 (P < 0.0001)
- Valsalva LVOT gradient, Δ least squares mean
- −39.2 ± 5.0 (P < 0.0001)
- ≥1 NYHA class improvement
- 77.8% [95% CI: 61.0-94.5]; P < 0.0001
- KCCQ-Clinical Summary Score change
- 12.3 ± 3.3 [P < 0.001]
- NT-proBNP ratio
- 0.35 [95% CI: 0.26-0.48]; P < 0.0001
Further pooled results
Aficamten withdrawal while on disopyramide
- Return of LVOT obstruction, worsening symptoms and NT-proBNP increase to baseline
Disopyramide withdrawal while on aficamten
- Did not impact efficacy
Safety
Safety events with aficamten or disopyramide withdrawal; AF after disopyramide withdrawal
- Safety events associated with withdrawal
- 0
- AF episodes after disopyramide withdrawal
- 0
Original publication
Concomitant Aficamten and Disopyramide in Symptomatic Obstructive Hypertrophic Cardiomyopathy. JACC Heart Fail. Published 2 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →