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Aug 22, 2024 | 
jamanetwork.com | Milind Y. Desai |Anjali T. Owens |Kathy E. Wolski
Key PointsQuestion What is the longer-term efficacy of mavacamten in reducing the need for septal reduction therapy (SRT) in patients with obstructive hypertrophic cardiomyopathy (HCM)?
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Sep 28, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: So in the last few minutes, I'm going to ask each of you as you look into the future caring for our patients with obstructive HCM [hypertrophic cardiomyopathy] and non-obstructive HCM, what other things are you excited about? We talked a little bit about the myosin inhibitors, but clearly there are other things that Milind alluded to that are coming down the pike for us. It's an exciting time to be in HCM position.
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Sep 28, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: Let me take that point over to Michelle. So, Michelle, you said I gave you a softball earlier, but this is the hard one. What is left in terms of unanswered questions, and to build on Milind’s point, what does disease modification mean? You’re a heart failure doctor, like myself . Are we affecting the natural history of disease? What do we need to know to get that answer? Michelle M. Kittleson, MD, PhD: I think Milind started off the conversation. He punted the volleyball to me.
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Sep 28, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: So Jim, let me ask you in the last few minutes that we have, what's your approach in the real world to really implementing these agents? What kind of infrastructure is there? How do you select the patient? How do you go about doing this in the real world? James Januzzi, MD: Yeah, great question. This illustrates the importance of a team sport here.
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Sep 21, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: And speaking of options which we all like to have, Andrew, can you tell us about the next in class cardiac myosin inhibitor aficamten, which is currently still in clinical trials, not yet FDA approved, but walk us through the data we have for that agent? Andrew Wang, MD: Aficamten is a cardiac myosin inhibitor that works at a different site on the myosin head, but also reduces the actin-myosin interaction by inhibiting myosin ATPase.
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Sep 21, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: So, Milind, let's go back to you and give us some of the data on mavacamten specifically, which we know is the only FDA approved cardiac myosin inhibitor approved in April of 2022. Give us some of the background data, top line results. You don't have to give too much of the weeds, although I know you know them all, on the trials we've had. I'll ask you to really focus maybe on the early earlier trials, PIONEER-HCM and of course the pivotal phase 3 EXPLORER-HCM trial.
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Sep 14, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Anjali Owens, MD: With this novel mechanism of action modulating contractility where do you think that these agents could fill a gap in the care of our obstructive HCM [hypertrophic cardiomyopathy] patients? Andrew Wang, MD: So as Milind said, these drugs cardiac myosin inhibitors are very potent, but titratable drugs to help reduce hypercontractility, we think of the normal person's ejection fraction is greater than 55%.
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Sep 14, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Seemal R. Desai
Anjali Owens, MD: So Milind, let's start with you. How is the advancement in the knowledge about pathophysiology? You talked to us about mice and heavy chain myosin binding protein C [MYBPC3] sarcomere variance at the very beginning. How is further understanding of that pathophysiology led to the development of new therapies? Milind Desai, MD, MBA: You take a genetic abnormality, recognize it, dissect it, and then understand enough about it to then go and develop a precision tool to work on it.
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Sep 7, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Seemal R. Desai
Anjali Owens, MD: Andrew, take us back to the patient who maybe hasn't had a good response to the beta blocker or calcium channel blocker, even a combination of those 2 agents. How do you approach talking to a patient and selecting the right septal reduction therapy [SRT], and what are the challenges that come with those invasive therapies?
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Sep 7, 2023 | 
hcplive.com | Anjali T. Owens |Andrew Wang |James L. Januzzi |Michelle M. Kittleson |Milind Y. Desai
Sep 7, 2023Andrew Wang, MD, comments on the treatment algorithm for symptomatic oHCM, highlighting treatment guidelines, and James Januzzi, MD, reviews treatment selection for oHCM through the lens of the patient’s quality of life. Anjali Owens, MD: So let's start with guideline directed first-line therapies for symptomatic obstructive HCM [hypertrophic cardiomyopathy]. Andrew, do you want to walk us through what our algorithm is?
