The effect of long-term use of Mavakatai/Mafantuo after two years

As the world's first cardiac myosin inhibitor, mavacamten's long-term effects have always been an important focus in the cardiac field. As the study period prolongs, data from overseas shows that patients who have continued to use Mavaceta for about two years generally show a trend of stable improvement in obstruction, improvement in exercise tolerance, and optimization of myocardial structure, making it gradually regarded as a long-term management drug for hypertrophic cardiomyopathy (HCM).

The core of long-term efficacy lies in its sustained suppression of left ventricular outflow tract obstruction. Mavacamten achieves long-term control of myocardial hypercontraction by reducing myosin interactions, not only reducing obstructive pressure at rest and during exercise, but also reducing chest tightness, dyspnea or exercise-induced fatigue due to increased activity. During the two-year observation period, most patients were able to maintain relatively stable hemodynamic indicators and showed continued improvement in exercise capacity, which means that the drug effect is not short-lived, but a relatively stable physiological regulation mechanism.

Of note is the myocardial remodeling signal. Data show that some patients with long-term use of Mavacamten have improved left ventricular wall thickness, atrial size and other structural parameters to varying degrees, which indicates that the drug may reduce the trend of myocardial fibrosis caused by long-term pressure load. Although these results still require further confirmation with longer follow-up, this phenomenon has potential breakthrough significance in HCM, a disease that traditionally has "irreversible myocardial changes" as its core pathology.

In terms of quality of life, two years of continuous use generally leads to more stable daily activities, including walking up and down stairs, recovery time after exercise, and reduction of nighttime symptoms. The patient's life rhythm is closer to that of the normal population, and psychological pressure is also reduced. The long-term effects are particularly significant for young and middle-aged patients whose lives are poorly controlled by traditional drugs and whose lives are repeatedly affected by obstructive symptoms.

Reference materials:https://bnf.nice.org.uk/drugs/mavacamten/