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Hypertrophic CardiomyopathyMay 2024

What the SEQUOIA-HCM Trial Found — Aficamten for Hypertrophic Cardiomyopathy

SEQUOIA-HCM tested aficamten, a daily oral cardiac myosin inhibitor, in 282 adults with symptomatic obstructive hypertrophic cardiomyopathy. After 24 weeks, exercise capacity improved meaningfully and most secondary measures favored aficamten.

What the trial was testing

The SEQUOIA-HCM enrolled 282 patients with hypertrophic cardiomyopathy. The study was sponsored by Cytokinetics and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

1.7 mL/kg/min greater rise in peak oxygen uptake — a real exercise gain.

New England Journal of Medicine · 2024 · NCT05186818

These findings — that greater improvement in peak exercise oxygen uptake on aficamten over 24 weeks — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 282 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with hypertrophic cardiomyopathy, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Aficamten is under FDA review and not yet approved as of early 2026. A related drug, mavacamten (Camzyos), is FDA-approved for the same condition and available now. Ask a cardiologist who specializes in hypertrophic cardiomyopathy about approved options or whether you qualify for an aficamten trial.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.