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Drug Evaluations

Omecamtiv mecarbil: a new cardiac myosin activator for the treatment of heart failure

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• Paper on the mechanistic basis of omecamtiv mecarbil on cardiac contractility

  • Malik FI, Morgan BP. Cardiac myosin activation part 1: from concept to clinic. J Mol Cell Cardiol. 2011 Oct;51(4):454–461.
  • Morgan BP, Muci A, Lu PP, et al. Discovery of omecamtiv mecarbil the first, selective, small molecule activator of cardiac myosin. ACS Med Chem Lett. 2010 Aug 20;1(9):472–477.

• Review of the discovery of omecamtiv mecarbil

  • Shen YT, Malik FI, Zhao X, et al. Improvement of cardiac function by a cardiac myosin activator in conscious dogs with systolic heart failure. Circ Heart Fail. 2010;3(4):522–527.
  • Bakkehaug JP, Kildal AB, Engstad ET, et al. Myosin activator omecamtiv mecarbil increases myocardial oxygen consumption and impairs cardiac efficiency mediated by resting myosin ATPase activity. Circ Heart Fail. 2015;8(4):766–775.
  • Utter MS, Ryba DM, Li BH, et al. Omecamtiv mecarbil, a cardiac myosin activator, increases Ca2+ sensitivity in myofilaments with a dilated cardiomyopathy mutant tropomyosin E54K. J Cardiovasc Pharmacol. 2015;66(4):347–353.
  • Teerlink JR. A novel approach to improve cardiac performance: cardiac myosin activators. Heart Fail Rev. 2009 Dec;14(4):289–298.
  • Liu Y, White HD, Belknap B, et al. Omecamtiv mecarbil modulates the kinetic and motile properties of porcine beta-cardiac myosin. Biochemistry. 2015 Mar 17;54(10):1963–1975.
  • Teerlink JR, Malik FI, Kass DA. Letter by Teerlink et al. regarding article, “myosin activator omecamtiv mecarbil increases myocardial oxygen consumption and impairs cardiac efficiency mediated by resting myosin ATPase activity”. Circ Heart Fail. 2015;8(6):1141.
  • Teerlink JR, Clarke CP, Saikali KG, et al. Dose-dependent augmentation of cardiac systolic function with the selective cardiac myosin activator, omecamtiv mecarbil: a first-in-man study. Lancet. 2011 Aug 20;378(9792):667–675.

•• First-in-man study of omecamtiv mecarbil

  • Cleland JG, Teerlink JR, Senior R, et al. The effects of the cardiac myosin activator, omecamtiv mecarbil, on cardiac function in systolic heart failure: a double-blind, placebo-controlled, crossover, dose-ranging phase 2 trial. Lancet. 2011 Aug 20;378(9792):676–683.

•• Phase II study of omecamtiv mecarbil in patients with systolic heart failure

  • Greenberg BH, Chou W, Saikali KG, et al. Safety and tolerability of omecamtiv mecarbil during exercise in patients with ischemic cardiomyopathy and angina. JACC Heart Fail. 2015 Jan;3(1):22–29.

•• Clinical study on the effects of omecamtiv mecarbil in patients with ischemic cardiomyopathy and angina

  • Vu T, Ma P, Xiao JJ, et al. Population pharmacokinetic-pharmacodynamic modeling of omecamtiv mecarbil, a cardiac myosin activator, in healthy volunteers and patients with stable heart failure. J Clin Pharmacol. 2015;55(11):1236–1247.
  • Jerling M, Chew T, Escandon RD, et al. Oral bioavailability of the selective cardiac myosin activator CK-1827452: chronic oral inotropic therapy for heart failure? J Card Fail. 2007;13(6, Suppl. 2):S148.
  • Cytokinetics provides updates from Phase I clinical trials of CK-1827452 results from three trials support ongoing clinical development program [Internet]. 2008 [cited 2015 Nov 17]. Available from: http://ir.cytokinetics.com/phoenix.zhtml?c=142156&p=irol-newsArticle&ID=1165647.
  • Teerlink JR Chronic oral study of myosin activation to increase contractility in heart failure(COSMIC-HF): final results from a double-blind, randomized, placebo-controlled, multicenter study. Late-Breaking Clinical Trial Session at the American Heart Association (AHA) Scientific Sessions; 2015.
  • Teerlink JR ATOMIC-AHF: acute treatment with omecamtiv mecarbil to increase contractility in acute heart failure: results from ATOMIC-AHF - European Society of Cardiology (ESC) 2013 Congress.
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