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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2026, Vol. 31 ›› Issue (9): 1249-1255.doi: 10.12092/j.issn.1009-2501.2026.09.011

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Evidence-based progress and future therapeutic directions of myosin inhibitor aficamten—from mechanistic exploration to clinical practice

Qi WANG1(), Yunzeng ZOU2,*()   

  1. 1. Department of General Medicine, Zhongshan Hospital of Fudan University
    2. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200034, China
  • Received:2026-02-14 Revised:2026-06-04 Online:2026-09-26 Published:2026-10-08
  • Contact: Yunzeng ZOU E-mail:wang.qi@zs-hospital.sh.cn;zou.yunzeng@zs-hospital.sh.cn

Abstract:

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiomyopathy, in which patients with the obstructive form (oHCM) face an elevated risk of heart failure and arrhythmias due to left ventricular outflow tract (LVOT) obstruction. Traditional drug therapies primarily aim to alleviate symptoms and are often unable to reverse the pathophysiological progression of the disease. The advent of cardiac myosin inhibitors (CMIs) marks the entry of HCM treatment into a new era of targeted intervention addressing the core disease mechanism. With its unique pharmacokinetic profile—such as a short half-life and low risk of drug-drug interactions—along with outstanding efficacy and safety, Aficamten has been demonstrated in multiple key clinical trials to significantly improve exercise capacity, symptoms, and quality of life in patients with oHCM, while also showing potential for reversing cardiac remodeling. This article systematically reviews the mechanism of action, pharmacological properties, clinical development history of Aficamten, and its position within the HCM treatment landscape, and offers perspectives on future research directions for personalized therapy and disease-modifying effects.

Key words: Aficamten, cardiac myosin inhibitors, hypertrophic cardiomyopathy, left ventricular outflow tract obstruction, targeted therapy

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