Contemporary OB/GYN week in review: Elinzanetant, breast cancer, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, October 07 - Friday, October 11, 2024), and click each link to read and watch anything you may have missed.

FDA accepts elinzanetant NDA for vasomotor symptoms in menopause

The FDA has accepted the New Drug Application for elinzanetant (Bayer) for the potential treatment of moderate-to-severe vasomotor symptoms (VMS) in menopause. An expected target approval date has not been announced.

In OASIS 1 and 2, a reduction in VMS frequency and severity was reported among participants receiving elinzanetant. At week 4 and week 12, the mean frequency reductions were -3.29 and -3.22, respectively. These reductions were above the clinically relevant threshold of 2 VMS per day vs placebo. For severity, these reductions were -0.33 and -0.40, respectively.

"The good news was that [elinzanetant] we met its primary objective," Pinkerton said. "Hot flashes were significantly reduced at 12 weeks in this population of women who were not as severe as those in OASIS 1 and 2—more like you would see in your clinical practice—significantly reduced compared to placebo at 12 weeks, and then maintained that efficacy throughout the 52 weeks.”

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Association between breast cancer and reproductive health noted

The age at menarche, number of pregnancies, and number of full-term pregnancies are reduced among women in the Caribbean with breast cancer (BC), according to a recent study published in JAMA Network Open.

Rates of women experiencing menarche before age 12, no pregnancies, nulliparity, and natural menopause before the age of 45 years increased over time. However, total abdominal hysterectomy with salpingo-oophorectomy was less common in the younger birth groups.

An increase in BC associated with positive germline variants increased over time, from 9.6% before 1950 to 17.1% from 1970 onward. A younger age at BC diagnosis was linked to increased risks of younger age at menarche, fewer pregnancies, fewer FTPS, younger age at menopause, and older age at first pregnancy.

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Lower estradiol linked to abdominal aortic calcification risk

Postmenopausal women with reduced Estradiol (E2) levels are more likely to experience abdominal aortic calcification (AAC), according to a recent study published in Fronteirs in Endocrinology.

Participants were grouped based on E2 tertiles, with cohorts including Tertile 1 at 2.12 to 3.57 pg/mL, Tertile 2 at 3.60 to 7.04 pg/mL, and Tertile 3 at 7.06 to 38.4 pg/mL. Estrogen concentrations in patients were evaluated using the formula “ln ( E 2 ) = ln ( E 2 , pg/mL ).”

There were 614 postmenopausal women included in the final analysis. EAAC rates were 16.6% in Tertile 1, 9.8% in Tertile 2, and 8.3% in Tertile 3, indicating significantly increased EACC prevalence among women with reduced E2 levels.

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Reduced opioid dispensing after surgery reported among youths

A decrease in opioid dispensing following surgical procedures has been reported among youths, according to a recent study published in JAMA Network Open.

The rate of opioid prescription fills up to 14 days before a procedure vs 7 days after was reported as the primary outcome. Secondary outcomes included refills up to 30 days, 31 to 60 days, and 81 to 180 days after surgery in morphine milligram equivalents (MME).

A decrease in the proportion of filled prescriptions and quality dispensed was observed in 2017, but similar preoperative fill rates were noted. Patients aged 18 to 20 years were more likely to have preoperative prescriptions. Additionally, preoperative prescriptions were more likely to be filled for procedures unlikely to lead to severe postoperative pain.

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Transforming public health through vaccinations

Vaccinations have profoundly transformed public health, marking one of the most significant advancements in medical science. From Edward Jenner’s pioneering work in the late 18th century to the development of modern vaccines, immunization has drastically reduced the incidence of many diseases and saved millions of lives.

However, in recent years and particularly since the COVID-19 pandemic, vaccination rates have waned and vaccine hesitancy has risen. The spread of false information through social media platforms has fueled skepticism and hesitancy, and the politicization of vaccines, particularly those for COVID-19, has polarized opinions and affected vaccine acceptance across infectious disease types, racial and ethnic groups, and education levels. This trend has significant implications for public health strategies, but the drivers of vaccine hesitancy are complex and diverse across sociocultural groups, suggesting that understanding and reversing these trends will take diverse groups and efforts.

Combating misinformation is one area that is crucial for improving vaccine uptake. As primary care providers for women, our role is vital to offer accurate, evidence-based information about the benefits of vaccination and equip ourselves with strategies to counter misinformation and myths about vaccines. With the upcoming influenza and RSV seasons, continued COVID-19 surges, and climbing neonatal pertussis numbers, now is the time to be proactive in efforts to boost vaccine confidence for all our patients.

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