MRIs for ICD and Pacemaker Patients

Here is an informative new video from our friend Doug Rachac that nicely explains the safety of MRIs for patients with implantable defibrillators and pacemakers.

I wrote a blog piece about this same issue a few years back. Here it is:

Yes We Scan! ICDs and MRIs

And a few other relevant blog entries here on HCMBeat:

Study Shows MRIs Safe for Pacemaker & ICD Patients

Chapter 3: MRI Safety for ICD & Pacemaker Patients

Safety of MRIs With Abandoned Leads

Last year, Doug wrote this blog entry for HCMBeat specifically about magnets and airports. Read that here:

Blogger Doug Rachac – Magnets and Airports: Should ICD Patients Be Afraid?

And, you can find more about ICDs from Doug on his YouTube Channel.

Overweight HCM Patients Fare Worse

This week, researchers from the eight HCM centers comprising the Sarcomeric Human Cardiomyopathy Registry [SHARE Registry] published a paper that every HCM patient should take to heart.

The sobering findings are that overweight HCM patients have a higher incidence of obstruction, heart failure and atrial fibrillation than their normal weight counterparts. As a result of this study, the researchers suggest heightened attention to weight management and exercise in order to prevent disease-related progression and complications.

Continue reading “Overweight HCM Patients Fare Worse”

Data From HCM Registry to Inform Personalized HCM Treatment in Future

Several years ago, researchers from the University of Virginia (UVA) and the University of Oxford announced a joint project involving a large international registry of hypertrophic cardiomyopathy (HCM) patients to facilitate research into HCM. Backed with funding from the National Heart Lung and Blood Institute, this project, known as the HCM Registry, includes data from 2,750 patients with HCM at 44 sites in six countries. 

This week, researchers from UVA announced their first findings from this registry which suggest that HCM patients can be separated into two basic groups:

  1.  Patients with a known genetic mutation who are not obstructed but have scarring of the heart muscle;
  2. Patients who do not have a known genetic mutation and do not exhibit scarring, but who do have a significant amount of obstruction to blood flow.

According to Dr. Christopher Kramer of UVA, this information should provide doctors with information that allows them to better assess the degree of risk to any particular patient, and to help inform a treatment strategy for each patient based on his or her unique profile.

Dr. Harry Lever Speaks Out About Problems With Generic Drugs

This Medscape article highlights the extraordinary efforts of Dr. Harry Lever, Director of the Cleveland Clinic’s Hypertrophic Cardiomyopathy Center, in educating patients and physicians alike about quality issues with generic drugs.  Dr. Lever has been instrumental in publicizing the fact that generic drugs are NOT always the same as their name brand counterparts, and that foreign generics are not put through the same level of scrutiny as drugs in the U.S.

Journalist Katherine Eban who recently published a book entitled Bottle of Lies: The Inside Story of the Generic Drug Boom is quoted in the Medscape article and has this to say:

“Dr Lever has been tireless in raising the alarm publicly, and with the FDA, about those generics that he felt were actively harming his patients, and remarkably, in case after case, he has been correct in his clinical judgments, and often far ahead of the FDA in detecting problematic drugs. His patients, many of whom I interviewed for Bottle of Lies, are grateful to him, as we all should be.”

And, in June of 2014, Dr. Lever discussed quality control issues with generic Toprol and was interviewed for this article featured in the New York Times.  Dr. Lever was alerted to the issue when many of his patients complained of a return of symptoms after having switching from the brand drug Toprol to one of the many generic formulations of the drug.

So, after all of these experiences, what does Dr. Lever himself do when prescribing drugs for his patients?  As the Medscape article goes on to say:

Despite all his misgivings, Lever still prescribes generic drugs. Brand name drugs are simply too expensive, or patients’ insurers will cover only generics. However, he does try to specify that the generics come from American companies that manufacture in this country under the eye of the FDA.

HCMBeat would like to join with Dr. Lever’s patients and thank him for his tireless efforts on behalf of HCM patients.  It is greatly appreciated.

Sudden Death in HCM Less Common than Thought

A recent study by Canadian researchers published in the American Heart Association journal Circulation found a much lower incidence of  HCM related sudden death than expected.  The study included deaths in individuals that occurred between the ages of 10 and 45 in the Canadian province of Ontario between 2005 and 2016.  According to lead author Dr. Paul Dorian of the University of Toronto, the expectation was that 1 incident of sudden cardiac death would be identified in every 100 to 200 people who had HCM.  Instead, researchers found that the likelihood of sudden death of HCM patients was instead only about 1 in 3,000 people/year.

The study also found that found 7 in 10 HCM-related sudden deaths occurred in people not previously diagnosed with the condition.  Men had more than 5 times the risk of sudden cardiac death than women, and most deaths occurred during rest or light activity: only about 17% happened during or immediately after exercise. 

As a result of the study, according to Dr. Dorian, “our findings allow us to lower the temperature on our degree of worry about the condition.”

Another clinical take away from the study, according to the researchers, is that current exercise guidelines for HCM patients may be too restrictive.

HCM Clinical Trials – the Latest News

NEWS FROM MYOKARDIA

MyoKardia recently announced a new clinical trial of its drug, mavacamten (formerly known as MYK-461) which will compare the clinical results of mavacamten with septal reduction therapies currently used in clinical practice, i.e. the open heart surgical procedure known as septal myectomy and the catheter based procedure known as alcohol septal ablation.

The study will be run by the Cleveland Clinic with Dr. Milind Desai serving as principal investigator.  MyoKardia expect to begin enrolling patients in early 2020.

Read the press release here.

 

NEWS FROM CYTOKINETICS:

Cytokinetics released positive data from its Phase 1 study of the drug currently known as CK-274 in a poster session at the HFSA 23rd Annual Scientific Meeting in Philadelphia.  The study found that CK-274 was safe and well tolerated, while no serious adverse events or negative changes to vital signs, ECGs or laboratory tests were observed.

The company will now be moving into a Phase 2 clinical trial of CK-274 in patients with obstructive hypertrophic cardiomyopathy, expected to begin in late 2019.

Read their press release here.

 

 

DISCLOSURES:  HCMBEAT HAS RECEIVED PAST UNRESTRICTED EDUCATIONAL GRANTS FROM MYOKARDIA.  ADDITIONALLY, CYNTHIA BURSTEIN WALDMAN OF HCMBEAT SERVES AS A PATIENT ADVISOR ON THE STEERING COMMITTEE FOR MYOKARDIA’S EXPLORER TRIAL.

Dr. Srihari Naidu Talks About HCM Medical Education

Recently, Cynthia Waldman of HCMBeat corresponded with Dr. Srihari S. Naidu of Westchester Medical Center the second edition of an HCM textbook he recently edited, as well as about medical education surrounding hypertrophic cardiomyopathy in general. What follows is a transcript of their correspondence (which has been slightly edited for readability).

Continue reading “Dr. Srihari Naidu Talks About HCM Medical Education”

2 Companies Testing Drugs for HCM

Updated with recent data on mavacamten from ESC Paris, 2019.

HCM Beat

Two San Francisco based companies are now conducting clinical trials for three drugs specifically targeting HCM.

MyoKardia, which was founded in 2012 by a group of HCM researchers (including Stanford’s James Spudich, one of the founders of Cytokinetics – the second company conducting a HCM drug trial – see below), was the first entrant into the HCM area with the development of its drug, mavacamten (formerly known as MYK-461).

Mavacamten is currently the subject of the Phase 3 EXPLORER-HCM clinical trial for obstructive HCM, now fully enrolled with results expected in 2020, as well as the Phase 2 MAVERICK-HCM trial for non-obstructive HCM, with results are expected later this year.

And, MyoKardia announced this week that it is will begin testing a second drug for HCM.  The new drug, currently known as MYK-224, is the subject of a new Phase 1 clinical trial.  This drug targets the sarcomeric…

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ICD Patients – Combat ICD Anxiety

This informative blog article written by a social worker for the University of Michigan’s Health Blog has some great tips on how to deal with anxiety when living with an ICD.

I recommend it.

2 Companies Testing Drugs for HCM

Two San Francisco based companies are now conducting clinical trials for three drugs specifically targeting HCM.

MyoKardia, which was founded in 2012 by a group of HCM researchers (including Stanford’s James Spudich, one of the founders of Cytokinetics – the second company conducting a HCM drug trial – see below), was the first entrant into the HCM area with the development of its drug, mavacamten (formerly known as MYK-461).

Mavacamten is currently the subject of the Phase 3 EXPLORER-HCM clinical trial for obstructive HCM, now fully enrolled with results expected in 2020, as well as the Phase 2 MAVERICK-HCM trial for non-obstructive HCM, with results are expected later this year.

And, MyoKardia announced this week that it is will begin testing a second drug for HCM.  The new drug, currently known as MYK-224, is the subject of a new Phase 1 clinical trial.  This drug targets the sarcomeric proteins of the heart muscle like MyoKardia’s first drug, mavacamten. According to the press release, MYK-224 may provide dosing advantages for some patients over other drugs.

Cytokinetics, a company founded in 1998 which was previously focused on other muscle related conditions like ALS, has decided to set its sights on HCM.  Cytokinetics is currently conducting a Phase 1 clinical trial assessing the safety and tolerability of its drug CK-274, a cardiac myosin inhibitor intended to reduce cardiac contractility.

At a recent cardiology meeting in Boston, Cytokinetics presented data showing that CK-274 decreased cardiac contractility in healthy animals.

Stay tuned to HCMBeat for the latest details and updates about these drugs.

UPDATE:  Data Presented at August 31, 2019 European Society of Cardiology Congress in Paris

At ESC, MyoKardia announced results from the PIONEER-Open Label Extension study from 12 patients who had been enrolled in the Phase 2 PIONEER-HCM study of mavacamten. These patients were evaluated after a total of 36 weeks on the drug.  The study results showed reduction in both resting and provoked left ventricular outflow tract gradients, while left ventricular ejection fraction remained normal at all times.  Further, certain biomarkers of heart disease showed improvement with mavacamten treatment.  Most strikingly, NT-proBNP, a blood indicator of cardiac wall stress, decreased almost to normal.   

DISCLOSURES:  HCMBEAT HAS RECEIVED PAST UNRESTRICTED EDUCATIONAL GRANTS FROM MYOKARDIA.  ADDITIONALLY, CYNTHIA BURSTEIN WALDMAN OF HCMBEAT SERVES AS A PATIENT ADVISOR ON THE STEERING COMMITTEE FOR MYOKARDIA’S EXPLORER TRIAL.