Omecamtiv mecarbil did not improve measures of exercise capacity over a 20-week period in well-treated patients with chronic heart failure with reduced ejection fraction (HFrEF), according to researchers presenting findings from the METEORIC-HF trial at ACC.22.

The trial enrolled 276 patients who were already receiving guideline-directed medical therapy for HFrEF at maximally tolerated doses. Two-thirds of the participants were randomly assigned to receive omecamtiv mecarbil on top of their normal drug regimen and one-third received a placebo. Researchers performed a variety of tests to assess participants' exercise capacity before the study and after 20 weeks.

Overall, researchers found no difference between the study groups in terms of the trial's primary endpoint, the change in peak oxygen uptake as measured by cardiopulmonary exercise testing. There was also no difference in terms of the study's secondary endpoints, which included a variety of other tests used to assess heart and lung fuction during exercise. Participants also showed no improvement in terms of their day-to-day physical activity, as measured by wearable accelerometers, or their perceived functional capacity after taking omecamtiv mecarbil.

In previous trials, omecamtiv mecarbil was found to offer significant benefits in terms of reducing the time to cardiovascular death or first heart failure event in patient with HFrEF; however, these new findings suggest the drug does not help to overcome the day-to-day functional limitations that are a hallmark of the disease, according to Gregory D. Lewis, MD, the study's lead author.

"This is unfortunately not the first time that there has been a medication that improves outcomes but doesn't improve exercise capacity," Lewis said. "There is a persistent frontier in heart failure to help patients improve their functional capacity, and it seems like we may need to look beyond our current and expanding pharmacotherapy regimen to address this need."

Meanwhile, Lewis and colleagues noted that omecamtiv mecarbil appeared to be well tolerated, and no indication of safety concerns either during maximum exercise or at any other point in the trial were observed.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: ACC Annual Scientific Session, ACC22, Stroke Volume, Exercise Tolerance, Heart Failure, Ventricular Function, Left, Urea

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