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Mavacamten, a potential first-in-class cardiac myosin inhibitor for patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), showed improvement in health status compared to placebo at 30 weeks in EXPLORER-HCM trial
Findings of new analysis published simultaneously in The Lancet
Bristol Myers Squibb (NYSE: BMY) today announced a new analysis of data from the Phase 3 EXPLORER-HCM study evaluating mavacamten, an investigational, first-in-class cardiac myosin inhibitor, in patients with obstructive hypertrophic cardiomyopathy (oHCM), which was presented at the American College of Cardiology’s 70th Annual Scientific Session (ACC.21), with simultaneous publication in The Lancet. At 30 weeks, the change in Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ OSS) was greater in mavacamten patients than placebo, with similar benefits across all KCCQ subscales. Moreover, a greater proportion of mavacamten patients achieved a very large, clinically meaningful improvement (≥20 points) in the KCCQ OSS, compared to placebo, 36% [33/92] vs. 15% [13/88]. A change of at least 5 points is required to be considered clinically significant. These results were presented today as part of the Featured Clinical Research I Session (403-09) in the Hot Topics Channel from 12:15-1:30 p.m. EDT.
"The KCCQ is a 23-item disease-specific questionnaire quantifying symptoms, physical function, social function and quality of life. By using this tool, we were able to demonstrate substantial clinical benefits for patients taking mavacamten in the trial, which diminished when patients ended treatment," said lead study investigator, John A. Spertus, M.D., M.P.H., Clinical Director of Outcomes Research at Saint Luke’s Mid America Heart Institute and the Lauer Missouri Endowed Chair and Professor of Medicine at the University of Missouri–Kansas City. "This new analysis of the EXPLORER-HCM data provides important insights into the benefits myosin inhibition can have in improving the health status of patients with severe obstructive hypertrophic cardiomyopathy, a chronic, often debilitating condition."
In the Phase 3, double-blind, placebo-controlled trial, patients with symptomatic oHCM (LVOT gradient ≥50 mmHg and NYHA Class II-III) were randomized 1:1 to mavacamten (n=123) or placebo (n=128) for 30 weeks, followed by an 8-week washout. The KCCQ was administered at baseline and Weeks 6, 12, 18, 30 and 38. Change from baseline in KCCQ scores were analyzed using mixed model repeated measures and responder analyses.
A total of 92 patients randomized to mavacamten and 88 randomized to placebo completed the KCCQ at both baseline and Week 30 (end of treatment).
At 30 weeks, the change in KCCQ OSS was greater with mavacamten than placebo (mean ± SD, 14·9±16 vs. 5·4±14; difference=9·1 (95%CI: 5·5-12·8; p<0·001), with similar benefits across all KCCQ subscales.
The proportion of patients with a very large change (KCCQ OSS ≥20 points) was 36% [33/92] vs. 15% [13/88], with an estimated absolute difference of 21% (95% CI=8·8%, 33·4%) and number needed to treat of 5 (95% CI=3, 11). A change of at least 5 points is considered clinically important. These gains returned to baseline after active treatment was stopped.
A greater proportion of patients in the placebo arm had no change or deterioration in their health status at Week 30.
"Mavacamten represents Bristol Myers Squibb’s ongoing dedication to improving the lives of patients, especially those living with chronic cardiovascular diseases such as oHCM, through scientific discovery," said Jay Edelberg, M.D., Ph.D., head, Heart Failure and Cardiomyopathy Development at Bristol Myers Squibb. "This new analysis of data from the Phase 3 EXPLORER-HCM trial further supports the scientific evidence suggesting the benefit mavacamten can have on improving health status, symptoms and quality of life in patients with symptomatic oHCM and we look forward to potentially bringing this important new therapy to patients next year."
About the Phase 3 EXPLORER-HCM Mavacamten Hypertrophic Cardiomyopathy Trial
The EXPLORER-HCM Phase 3 trial enrolled a total of 251 patients with symptomatic (NYHA Class II or III), obstructive hypertrophic cardiomyopathy. All participants had measurable left ventricular outflow tract (LVOT) gradient (resting and/or provoked) ≥50 mmHg at baseline.
The primary endpoint for EXPLORER-HCM was a composite functional analysis designed to capture mavacamten’s effect on both symptoms and function. Secondary endpoints were changes from baseline to week 30 in postexercise LVOT gradient, pVO2, proportion of patients with at least one NYHA class improvement, and measures of patientreported outcomes. Additional endpoints included changes from baseline to Week 30 in echocardiographic indices, circulating biomarkers, cardiac rhythm patterns and accelerometry.
About Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is a chronic, progressive disease in which excessive contraction of the heart muscle and reduced ability of the left ventricle to fill can lead to the development of debilitating symptoms and cardiac dysfunction. In HCM patients, exertion can result in fatigue or shortness of breath, interfering with a patient’s ability to participate in activities of daily living. Furthermore, HCM has also been associated with increased risks of atrial fibrillation, stroke, heart failure and sudden cardiac death. The most frequent cause of HCM is mutations in the heart muscle proteins of the sarcomere. HCM is estimated to affect one in every 500 people, however many patients remain undiagnosed and/or asymptomatic.
Mavacamten is a potential first-in-class, oral, allosteric modulator of cardiac myosin, under investigation for the treatment of conditions in which excessive cardiac contractility and impaired diastolic filling of the heart are the underlying cause. Mavacamten reduces cardiac muscle contractility by inhibiting excessive myosin-actin cross-bridge formation that results in hypercontractility, left ventricular hypertrophy and reduced compliance. In clinical and preclinical studies, mavacamten has consistently reduced biomarkers of cardiac wall stress, lessened excessive cardiac contractility and increased diastolic compliance.
About Bristol Myers Squibb
Bristol Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information about Bristol Myers Squibb, visit us at BMS.com or follow us on LinkedIn, Twitter, YouTube, Facebook and Instagram.
Cautionary Statement Regarding Forward-Looking Statements
This press release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 regarding, among other things, the research, development and commercialization of pharmaceutical products. All statements that are not statements of historical facts are, or may be deemed to be, forward-looking statements. Such forward-looking statements are based on historical performance and current expectations and projections about our future financial results, goals, plans and objectives and involve inherent risks, assumptions and uncertainties, including internal or external factors that could delay, divert or change any of them in the next several years, that are difficult to predict, may be beyond our control and could cause our future financial results, goals, plans and objectives to differ materially from those expressed in, or implied by, the statements. These risks, assumptions, uncertainties and other factors include, among others, the possibility that future study results will be consistent with the results to date, that mavacamten may not receive regulatory approval for the indication described in this release in the currently anticipated timeline or at all and, if approved, whether such product candidate for such indication described in this release will be commercially successful. No forward-looking statement can be guaranteed. Forward-looking statements in this press release should be evaluated together with the many risks and uncertainties that affect Bristol Myers Squibb’s business and market, particularly those identified in the cautionary statement and risk factors discussion in Bristol Myers Squibb’s Annual Report on Form 10-K for the year ended December 31, 2020, as updated by our subsequent Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and other filings with the Securities and Exchange Commission. The forward-looking statements included in this document are made only as of the date of this document and except as otherwise required by applicable law, Bristol Myers Squibb undertakes no obligation to publicly update or revise any forward-looking statement, whether as a result of new information, future events, changed circumstances or otherwise.
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