One year out: Fezolinetant displays patient satisfaction for managing hot flashes

In a recent interview, Risa Kagan, MD, FACOG, clinical professor at the University of California San Francisco, discussed the impact of fezolinetant (VEOZAH; Astellas Pharma) on vasomotor symptoms (VMS).

According to Kagan, hormonal estrogen therapy is the recommended treatment method for VMS by experts. Data has indicated hormone therapy as the most effective treatment for menopausal women without contraindications.

Fear of side effects, contraindications, and family histories of adverse reactions prevent many women from taking estrogen therapy, leading to increased symptom burden among these patients. This indicates a need for effective alternative treatment to help women with VMS.

Multiple off-label therapy methods are available for the treatment of VMS in menopausal women, but fezolinetant is the only neurokinin 3 receptor antagonist approved after rigorous clinical trials. Following double-blind, randomized controlled trials including women with moderate to severe VMS, the agent was released publicly in 2023.

Fezolinetant is taken as a daily pill and is associated with reduced frequency and severity of moderate to severe hot flashes, which Kagan described as the worst types of hot flashes. These results were sustained up to 52 weeks in the trials.

Additionally, Kagan noted that the secondary outcome of evaluating how quickly fezolinetant took effect indicated improved outcomes within 1 week of treatment. Additionally, frequency and severity were found to be reduced at week 4 and week 12.

Kagan highlighted that many of her patients taking fezolinetant will report symptom improvement within 1 week, with greater improvement at 4 weeks. If these patients have persisted efficacy and no adverse events by week 12, Kagan will recommend they continue treatment.

Additionally, Kagan stated that most patients did not have any complaints about fezolinetant. She also noted the importance of reduced severity. While many women will tolerate mild hot flashes, those that lead to sweating and disrupted activity massively impact quality of life. Fortunately, Kagan has found high patient satisfaction following treatment.

In a recent trial, investigators evaluated the patient global impression of change following fezolinetant use. Perceived self-improvement was reported by 69% of participants, indicating efficacy.