Est. 2026 · Armando Cuesta, MD, Founding Editor

The Vital Record

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Wednesday, 10 June 2026 edition — The Vital Record

MAPLE-HCM: Change in Peak VO₂ at 24 Weeks
Aficamten (Myqorzo)1.1Metoprolol-1.2mL/kg/min change from baseline
Primary endpoint. LS mean difference +2.3 mL/kg/min (95% CI 1.5–3.1; P<0.001). Source: NEJM 10.1056/NEJMoa2504654 / NCT05767346.

Clinical Trials

Aficamten Beats Metoprolol on Exercise Capacity in Phase 3 Head-to-Head Trial for Obstructive HCM

In 175 patients randomized over 24 weeks, the FDA-approved cardiac myosin inhibitor aficamten (Myqorzo) improved peak oxygen uptake by 1.1 mL/kg/min while metoprolol reduced it by 1.2 mL/kg/min — a 2.3 mL/kg/min treatment difference that drove superiority across five of six pre-specified secondary endpoints; left ventricular mass index did not differ significantly.

A Phase 3 head-to-head trial has found that aficamten (Myqorzo), an oral selective cardiac myosin inhibitor, outperformed the beta-blocker metoprolol on exercise capacity, symptoms, and hemodynamics in adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM). Primary results from the MAPLE-HCM trial (NCT05767346), sponsored by Cytokinetics, were presented at the European Society of Cardiology Congress in Madrid on August 30, 2025, and simultaneously published in The New England Journal of Medicine (DOI: 10.1056/NEJMoa2504654). Results were posted to ClinicalTrials.gov this week.

Trial Design

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