HCM Insights: Takeaways from our Conversation with Dr. Maron, Cardiologist

Research evidence excerpt

HCM Insights: Takeaways from our Conversation with Dr. Maron, Cardiologist

ty to safely and effectively relieve symptom

burden, allowing patients to feel and function better. Dr. Maron has observed growing

enthusiasm for using of these drugs earlier in the treatment algorithm, largely due to

the poor efficacy of traditional first-line agents like beta-blockers and calcium channel

blockers. Dr. Maron noted that ~60% to 70% of patients requesting aficamten are

receiving payer reimbursement / approval while ~30% are being denied or are being

forced into "step therapy" protocols where they must first fail a trial of mavacamten or

other older drugs before receiving coverage for aficamten.

The positive results from the MAPLE-HCM trial have created a low threshold

for doctors to shift patients from first line beta blockers on to aficamten

over mavacamten. Dr. Maron mentioned that the positive MAPLE data provides a

strong case for aficamten, as it showed overwhelming superior efficacy compared to

metoprolol, the current standard-of-care beta-blocker. While using beta-blockers is an

ingrained habit for many clinicians, many are beginning to recognize that CMIs like

aficamten are far more effective and relatively easy to use. He notes that if a patient

does not respond well to an initial low dose of a beta-blocker, there is now a very low

threshold to shift to a myosin inhibitor immediately.

Dr. Maron states that there are key pharmacological differences that might lead a

clinician to prefer aficamten over mavacamten for new patients. Dr. Maron points to

aficamten's shorter half-life and wider therapeutic window as key differentiators. These

traits mean that as a clinician titrates the dose upward, the changes in Ejection Fraction