MYOK:
The back taxes are going to be a worry. I'm proposing renaming this new code the Education Death Tax so that we can get people more interested. People get angry at death and taxes.
I initially found omecamtiv's mechanism analogous to giving HF patients dobutamine... temporary relief of symptoms followed by more rapid deterioration. Drugs that provide some benefit in HF patients tend to all reduce contraction (beta blockers, calcium channel antagonists), so it seemed bizarre to see CYTK swim counter to the data current. I've not followed CYTK much in years, so I'm unsure if they've found an appropriate niche. MYOK's strategy is a bit more in tune with strategies that work in the clinic, so it seemed a better initial approach.
Strangely, I actually thought the initial MYOK focus on genetically defined CM was garbage. Many of the mutations are in practically non-druggable proteins with unknown penetrance and dubious functional data, so I thought it fictional to be able to target those. They then backed off that approach, so I became more positive about the proposition.
