COLLIGO-HCM: Mavacamten (CAMZYOS) Effective in Obstructive HCM With Pankaj Arora, MD

Results from the COLLIGO-HCM observational study have indicated the safety and efficacy of mavacamten (CAMZYOS) in patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM), which is consistent with prior studies.1

Mavacamten is the first and only cardiac myosin inhibitor approved by the US Food and Drug Administration for the treatment of adults with symptomatic New York Heart Association (NYHA) class II-III obstructive HCM.1

COLLIGO-HCM is part of a larger program by parent company Bristol Myers Squibb, titled Worldwide AnalYsis on eFfectiveness AcRoss divErse populations for Real-world mavacamten use in patients with Hypertrophic CardioMyopathy (WAYFARER-HCM), which currently spans 7 countries and includes >3000 patients. It aims to investigate the effectiveness and safety of mavacamten on a larger scale, across a variety of conditions.1

COLLIGO-HCM, a global, retrospective data study, was presented at the European Society of Cardiology Congress 2025 in Madrid. The data indicated mavacamten’s association with reduced left ventricular outflow tract (LVOT) obstruction and improved symptom burden. The study also included a particularly racially diverse population (n = 278), including 23.2% Black, 5.4% Asian, and 4.3% Middle Eastern or North African patients.1,2

A total of 59.9% of patients achieved ≥1 NYHA class improvement by week 24, and 86.5% of patients with ≥12 weeks of follow-up and 94.4% of those with ≥24 weeks of follow-up had an NYHA classification of II or below, including 30.9% who had an NYHA classification of I. These proportions increased consistently throughout week 96. Additionally, by week 36, 90.3% of patients achieved mean LVOT gradients of ≤30 mmHg at rest, and 76.8% after Valsalva provocation.1

“COLLIGO challenges the one-size-fits-all approach, and it sort of broadens the scope of what should be second-line therapy and what should be first line,” Pankaj Arora, MD, said in an interview with HCPLive. “Beta blockers and calcium channel blockers currently in the guidelines, they are first line, but when patients continue to have symptoms or elevated gradients, myosin innovation using mavacamten is being considered.”

During the follow-up period, mean left ventricular ejection fraction (LVEF) remained at or above 61% compared to a baseline value of 66%. Temporary interruption due to LVEF ≤50% occurred in 11 patients, and permanent discontinuation took place in 3 patients. New-onset atrial fibrillation was only recorded in 8 patients, which is consistent with previously reported data from other studies.1

Most patients initiated mavacamten while also taking background medications, such as beta blockers or calcium channel blockers (n = 258). Of these, 26.4% discontinued ≥1 type of therapy, and 5% downtitrated their background medications after starting mavacamten. Arora highlighted this detail as a critical find, indicating potential room for further study.

Moreover, the nearly 60% of patients who improved ≥1 NYHA class highlight the potential for a paradigm shift in HCM treatment. Arora discussed what he views as an impending shift in the way clinicians and investigators will approach the disease and its effects.

“This is not just symptom management; it is functional restoration for these patients,” Arora told HCPLive. “It’s time to recalibrate our scales, time to rethink what we define as successful therapy in obstructive HCM.”

References

1. Bristol Myers Squibb Presents Real-World Outcomes of Camzyos (mavacamten) Across Four Continents at the European Society of Cardiology (ESC) Congress 2025. Bristol Myers Squibb. August 29, 2025. Accessed September 15, 2025. https://news.bms.com/news/corporate-financial/2025/Bristol-Myers-Squibb-Presents-Real-World-Outcomes-of-Camzyos-mavacamten-Across-Four-Continents-at-the-European-Society-of-Cardiology-ESC-Congress-2025/default.aspx

2. COLLIGO-HCM: A Multinational Observational Study of the Real-World Effectiveness of Mavacamten Among Patients with Symptomatic Obstructive Hypertrophic Cardiomyopathy (oHCM) (COLLIGO-HCM). ClinicalTrials.gov identifier: NCT06372457. Updated April 18, 2024. Accessed September 15, 2025. https://clinicaltrials.gov/study/NCT06372457?term=COLLIGO-HCM&rank=1