NICE (UK) positive for Myqorzo (aficamten) for treating symptomatic obstructive hypertrophic cardiomyopathy – Cytokinetics

NICE (UK): Aficamten can be used as an option to treat symptomatic obstructive hypertrophic cardiomyopathy in adults with a New York Heart Association class of 2 to 3.

It can only be used: i) as an add-on to individually optimised standard care including beta-blockers, non-dihydropyridine calcium-channel blockers or disopyramide, or ii) alone if these treatments are contraindicated, and iii) if the company provides it according to the commercial arrangement.

Why these recommendations were made: Standard care for symptomatic obstructive hypertrophic cardiomyopathy includes beta-blockers, non-dihydropyridine calcium-channel blockers or disopyramide. If symptoms persist then mavacamten or, if not already being used, disopyramide may be added. Aficamten works in a similar way to mavacamten and would be offered to the same population alongside standard care. Clinical trial evidence shows that aficamten is more effective than placebo at improving exercise capacity and NYHA class. Aficamten has not been directly compared in a clinical trial with mavacamten. But indirect comparisons suggest that it is likely to be as effective. There is a more flexible echocardiography schedule and a shorter titration period for aficamten than for mavacamten, which may be beneficial for people having the treatment. A cost comparison suggests the costs for aficamten are similar to or lower than mavacamten. So, it can be used.