A new treatment option for NHS patients in England living with obstructive hypertrophic cardiomyopathy (HCM) has been backed by the National Institute for Health and Care Excellence (NICE).
NICE has been recommended aficamten (Myqorzo) for people with this serious heart condition to help reduce symptoms including exhaustion, dizziness, breathlessness, chest pain and irregular heartbeat.
“We’re delighted that aficamten is going to be made available to people living with obstructive HCM”
Katharine McIntosh
On 30 July, the once-daily pill received NICE approval at the same time as authorisation also came through from the Medicines and Healthcare products Regulatory Agency (MHRA).
Obstructive HCM is a serious condition in which the heart muscle becomes stiff and struggles to pump blood around the body. It affects around 6,600 people in England and is inherited in around half of cases.
Standard treatment for obstructive HCM is with beta-blockers, non-dihyropyridine calcium-channel blockers or disopyramide.
Aficamten, developed by Cytokinetics, is now recommended by NICE as an alternative to mavacamten for use in NHS patients whose symptoms persist despite this standard-of-care treatment.
Both aficamten and mavacamten are reversible cardiac myosin inhibitors, which act to relieve the symptoms of obstructive HCM by reducing the excessive contraction of the heart muscle.
In clinical trials, aficamten was found to reduce the severity of obstructive HCM symptoms and improve the ability to exercise of people with the condition, the new NICE guidance states.
Although no evidence is currently available comparing the efficacy of the two drugs, the NICE guidance stated that aficamten was likely to be as effective as mavacamten.
And it could also be more suitable for some patients, because it has a more flexible echocardiography schedule and a shorter titration period, noted the institute.
Integrated care boards, NHS England and local authorities must now comply with the recommendations in this evaluation within 90 days of its date of publication.
The normal list price for aficamten is £1,180.52 for a 28‑tablet pack, but NICE said the NHS had secured a discount, though the value of this reduction was commercially confidential.
Katharine McIntosh, chief executive of the charity Cardiomyopathy UK, said: “We’re delighted that aficamten is going to be made available to people living with obstructive HCM.
“Obstructive HCM can have a considerable impact, with symptoms such as breathlessness, fatigue and a reduced ability to exercise making day-to-day life significantly more challenging.
“Mavacamten is currently the only treatment of this kind available, so having an additional option is very welcome,” Ms McIntosh said.
“And because aficamten may need fewer echocardiograms in the early stages of treatment, it could represent a more accessible treatment route,” she added.
“This outcome means greater choice for patients and the opportunity for more people living with obstructive HCM to benefit from treatment, feel better and live well,” Ms McIntosh said.