Mavacamten Monotherapy in Real-World Patients With Obstructive Hypertrophic Cardiomyopathy: Evidence From COLLIGO-HCM
Bibliographic record
Abstract
BACKGROUND: Mavacamten has been shown to improve cardiac function and symptoms in patients with symptomatic (New York Heart Association class II-III) obstructive hypertrophic cardiomyopathy (HCM). Clinical studies suggest that mavacamten monotherapy is efficacious and has a favorable safety profile, but limited evidence exists regarding monotherapy in real-world studies. This analysis aimed to describe the effectiveness and safety outcomes of mavacamten monotherapy in the real-world COLLIGO-HCM study (Mavacamten ObservationaL Evidence Global Consortium in Hypertrophic Cardiomyopathy). METHODS: Patient-level data recorded between April 2022 and February 2025 at 7 sites across 5 countries were extracted. Adult patients with a diagnosis of HCM from 2018 onwards were eligible for inclusion if they had ≥1 mavacamten prescription after the date of diagnosis. Patients were categorized based on background therapy status during mavacamten treatment: mavacamten monotherapy or mavacamten with background therapy (down-titration or no dose modification). RESULTS: Overall, 278 patients were included and received mavacamten (mavacamten monotherapy, n=88; mavacamten with background therapy, n=190). At month 9, most patients achieved ≥1 New York Heart Association class improvement from baseline (mavacamten monotherapy, 60.0%; mavacamten with background therapy, 61.0%). Improvements in resting and Valsalva left ventricular outflow tract gradients from baseline to month 9 were observed in both subgroups; mean left ventricular ejection fraction through month 9 remained ≥62.0% with mavacamten monotherapy and ≥61.4% with mavacamten with background therapy. Two patients in the mavacamten monotherapy subgroup and 1 patient in the mavacamten with background therapy subgroup permanently discontinued treatment owing to left ventricular ejection fraction <50%. CONCLUSIONS: Mavacamten monotherapy was associated with improvements in cardiac function and symptoms, and positive benefits to the risk profile over a 9-month follow-up period; this was consistent with improvements observed in patients treated with mavacamten with background therapy. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT06372457.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".