Delivery 7–10 daysMyqorzo (aficamten) 20 mg tablets
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Description
💊 Prescription second-generation cardiac myosin inhibitor for symptomatic obstructive hypertrophic cardiomyopathy.
▪︎ Aficamten 20 mg tablets (other strengths exist)
▪︎ Manufacturer: Cytokinetics
▪︎ FDA approval: 19 December 2025
🔬 How it works: the same principle as mavacamten — it reduces the fraction of myosin ready to engage actin, so an over-contracting heart relaxes better and outflow obstruction eases. The difference is pharmacokinetic: a shorter half-life and faster steady state make titration more flexible and over-suppression faster to reverse. 📊 Evidence: SEQUOIA-HCM (NEJM 2024) — improved peak oxygen uptake on exercise versus placebo; a 2026 analysis showed the effect held regardless of prior beta blocker therapy.
⚠️ Prescription-only. Echocardiographic monitoring of ejection fraction before starting, during titration and regularly thereafter is mandatory — excessive suppression of contractility is the class risk. Pregnancy is a contraindication. No head-to-head trials against mavacamten exist.
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