HI PGS, hope you are well, and hope you figure out how to pay the taxes on your grad student stipends once the tax reform is passed into law.
I have seen you many times comment that you like this approach over that for Omecamtiv by CYTK. That confuses me because it seems as if the two are targeting the exact same mechanism, except Omecamtiv increases the number of interactions between myosin and actin while Mavacamtem decreases those. What difference are you seeing here that causes concern for Omecamtiv over mavacamtem?
It's complicated and even cardiologists don't completely understand it. Is it heart failure that eventually kills oHCM patients or is it usually an electrical storm because the patient didn't realise that there was an issue in the first place. The ones that are diagnosed early because of family history will typically get an ICD. I have seen that in action on a friend with oHCM that went into VT during exercise. The heart does what is necessary to provide sufficient blood and it will remodel accordingly so I am not sure what lowering/raising the horse power does in the longer term as the vasovagal response will compensate for the lower horse power. Seems like surgery is still the way out for oHCM. As for HCM, some scar more easily than others when heavy loads are placed on the heart. There will be electrical signals via arrhythmia and ectopic beats. The folks that are fortunate enough to be symptomatic to those things will get diagnose early and have a high probability of getting it treated. The asymptomatic ones will end up on the heart failure path. The above for people that exercise. And then there are a lot of other risk factors for non-exercisers and I am not sure lowering the horse power is really the answer for that reason. Lots of complexity.
MYOK. new high . Poorgrad ...just wanted to chk in on your current view on MYOK. My understanding is that they will be presenting data on March 10th at ACC ...on their low dose trial . This data I think is important for the design of their final , and pivotal P 3 trial ...which is due to start in Q2 2018 This is the EXPLORER-HCM trial ...200-250 patients dosed daily for 6 mths . Should enroll fairly fast and ( my guess ) completed in 2019 .
From memory ..MYOK is treating the cause of hypertrophic cardiomyopathy ...beta blockers treat the symptoms
Anyway ...appreciate an update on your views of MYOK ...should you care to share . Kiwi
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