Efficacy and Safety of Pharmacologic Therapies in Nonobstructive Hypertrophic Cardiomyopathy: A Systematic Review.

What was studied

This review looked at drugs for nonobstructive hypertrophic cardiomyopathy (HCM) in adults. This form affects many people. It carries heavy illness. No approved drug changes the disease course. The team searched PubMed and other sources up to September 2025. Trials could be randomised or not. All were prospective. The results are a narrative summary. The trials covered 9 drug classes.

What they found

Cardiac myosin inhibitors cut left ventricular hypertrophy. They helped diastolic function. They also cut biomarkers markedly. Gains in exercise and symptoms varied. SGLT2 inhibitors helped diastolic function. They also helped atrial remodeling and biomarkers. This was in people with symptoms and type 2 diabetes. Valsartan and candesartan showed signs of remodeling. They showed no consistent gain in function. Some other classes had mostly neutral effects. Ninerafaxstat raised ventilatory efficiency and quality of life. This was in people with more symptoms at the start.

What it means for patients

The authors say drug response varies in nonobstructive HCM. They say it seems to depend on mechanism and disease stage. They say ongoing trials will be critical. These cover myosin inhibitors, SGLT inhibitors and new agents. New agents include ninerafaxstat and EDG-7500.

Why it is not certain yet

Gains in exercise and symptoms varied. A review can only be as good as the studies in it.

Source

Efficacy and Safety of Pharmacologic Therapies in Nonobstructive Hypertrophic Cardiomyopathy: A Systematic Review.

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