Prospects of heart failure pharmacotherapy: the latest news about omecamtiv mecarbil

Abstract

Over the past decades, an active scientific research has been continuing aimed on the search for medications that can increase myocardial contractility and improve the course of heart failure (HF). omecamtiv mecarbil, a drug from the group of cardiac myosin activators, heads the list of applicants for clinical use. By today, evidences have been collected for the ability of omecamtiv mecarbil to bind exclusively to the heads of cardiac myosin molecules without significantly affecting smooth or skeletal muscle myosin. omecamtiv mecarbil stabilizes pre‑step myosin conformation, enabling the greater number of its heads to participate in the working phase of systole.The article presents the results of several randomized clinical trials that studied the efficacy and safety of omecamtiv mecarbil in heart failure: ATOMIC‑AHF, COSMIC‑HF and GALACTIC‑HF. ATOMIC‑AHF showed a tendency to reduce the risk of developing supraventricular and ventricular arrhythmias in heart failure. COSMIC‑HF has proven the ability of omecamtiv mecarbil to improve the quality of life of patients with heart failure. GALACTIC‑HF may be a turning point in the medical treatment of heart failure. For the first time, clinical evidence of the ability of the selective cardiac myosin activator omecamtiv mecarbil to improve myocardial contractile function, reduce the severity of symptoms of heart failure and reduce the risk of cardiovascular death in patients with the reduced left ventricular injection friction was obtained. It is too early to draw final conclusions about the advisability of omecamtiv mecarbil administration for heart failure. The findings of new comparative randomized clinical trials, systemic reviews and meta‑analyses may possibly alter the standards of treatment of this pathology.