Core Insights - The primary results from the MAPLE-HCM trial indicate that aficamten demonstrates superiority over the standard-of-care beta-blocker metoprolol in improving exercise capacity in patients with obstructive hypertrophic cardiomyopathy (oHCM) [1][2][3] Company Overview - Cytokinetics is a biopharmaceutical company focused on developing treatments for cardiac muscle dysfunction, with aficamten being a key investigational drug currently under regulatory review in the U.S. and Europe [17][14] - Aficamten is a selective cardiac myosin inhibitor designed to reduce myocardial hypercontractility associated with hypertrophic cardiomyopathy (HCM) [11][12] Clinical Trial Details - The MAPLE-HCM trial is a Phase 3 randomized, double-blind study that enrolled 175 patients, comparing aficamten to metoprolol [2][4] - The primary endpoint was the mean change in peak oxygen uptake (pVO2) after 24 weeks, showing a significant improvement with aficamten (+1.1 mL/kg/min) compared to a decline with metoprolol (-1.2 mL/kg/min) [4][6] Efficacy Results - Aficamten showed a statistically significant least-squares mean difference of 2.3 mL/kg/min in pVO2 compared to metoprolol (p<0.0001) [4][6] - Aficamten also outperformed metoprolol in five of six secondary endpoints, including improvements in functional class and symptom burden [7][8] Safety Profile - The rate of adverse events was similar between aficamten and metoprolol, with aficamten showing a lower rate of treatment discontinuation due to adverse events [9] - Notably, hypertension was more common in the aficamten group, while dizziness was more prevalent in the metoprolol group [9] Regulatory Status - Aficamten is currently under review by the FDA with a target action date of December 26, 2025, and is also being evaluated by the European Medicines Agency [14][12]