Aficamten is a cardiac myosin inhibitor used to treat symptomatic obstructive hypertrophic cardiomyopathy in adults. Aficamten works by attenuating myocardial hypercontractility and left ventricular outflow tract obstruction, which are characteristics of oHCM.
- Mechanism
- Curator reviewed · 7 references
Aficamten is an oral, selective, and allosteric cardiac myosin inhibitor designed to directly target the underlying hypercontractility associated with hypertrophic cardiomyopathy (HCM). It binds reversibly to a distinct allosteric pocket on the beta-cardiac myosin motor domain, stabilizing the myosin in a specific conformation known as the "super-relaxed" or weak actin-binding state. By locking myosin heads in this state, aficamten slows the rate of phosphate release during the ATP hydrolysis cycle, which prevents the conformational changes required for myosin to transition into the force-generating, strongly actin-bound state. This action effectively decreases the number of active actin-myosin cross-bridges participating in the contractile cycle, thereby reducing the force generated by myosin at the cardiac sarcomere and attenuating left ventricular outflow tract (LVOT) obstruction.
- Primary indication
- Aficamten indicated for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) to improve functional capacity and symptoms.Curator reviewed · 1 structured indication
- Formula / weight
- C18H19N5O2 · 337.383 g/mol (avg)
- First approval
- United States, 2026 · European Union, 2026
- Also known as
- (R)-N-(5-(5-ethyl-1,2,4-oxadiazol-3-yl)-2,3-dihydro-1H-inden-1-yl)- 1-methyl-1H-pyrazole-4-carboxamide · (R)-N-(5-(5-ethyl-1,2,4-oxadiazol-3-yl)-2,3-dihydro-1H-inden-1-yl)-1-methyl-1H-pyrazole-4-carboxamide · 1h-pyrazole-4-carboxamide, n-((1r)-5-(5-ethyl-1,2,4-oxadiazol-3-yl)-2,3-dihydro-1h-inden-1-yl)-1-methyl- · N-((1r)-5-(5-ethyl-1,2,4-oxadiazol-3-yl)-2,3-dihydro-1h-inden-1-yl)- 1-methyl-1h-pyrazole-4-carboxamide
- Code names
- BAY3723113 · CK-3773274
- Brand names
Resolves to
IOVAZWDIRCRMTM-OAHLLOKOSA-NSMILESCCC1=NC(=NO1)C1=CC=C2[C@@H](CCC2=C1)NC(=O)C1=CN(C)N=C1What you can answer from here — as of September 13, 2026
Which drugs share a target with Aficamten, and which of those have an active Phase 3 trial?
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