A new treatment option for menopausal hot flushes and night sweats can now be used in the NHS when HRT is not suitable, with around 500,000 eligible to benefit. Fezolinetant is recommended to treat moderate to severe symptoms in final draft NICE guidance published recently.
Hot flushes and night sweats can hugely affect daily life by disrupting sleep, concentration, relationships and the ability to work. When HRT is not suitable, options have previously been limited. The fezolinetant 45 mg tablet is taken once a day and is a non-hormonal treatment that works by blocking the nerve pathways in the brain that trigger hot flushes and night sweats.
Helen Knight, director of medicines evaluation at NICE said:
“We know that menopausal hot flushes and night sweats can have a profound impact on quality of life and significantly affect overall wellbeing. For those who are unable to take HRT for varying reasons, options have historically been limited, and we have heard clearly from patients how difficult that can be. The evidence shows fezolinetant can meaningfully reduce symptoms, and was found to be cost effective, offering value for the taxpayer. This decision will give much-needed relief to those for whom HRT is unsuitable.”
HRT remains the first-line treatment option and, given its established benefits and the range of formulations now available, it’s likely most people with moderate to severe vasomotor symptoms would continue take it. However, fezolinetant addresses a real and important need for those who cannot or do not wish to use HRT.
Fezolinetant can be used when HRT is medically contraindicated for example in cases of deep vein thrombosis or pulmonary embolism. It can also be used following a clinical risk assessment in some cases of diabetes or heart disease. Those who do not wish to take HRT are also eligible for this treatment.
Fezolinetant is not recommended for those with current breast cancer, other estrogen-dependent cancers, or liver disease. Those who have previously had breast cancer or estrogen-dependent cancers and have completed treatment should undergo an individual risk assessment before being considered for fezolinetant, as clinical trial data in this group is not yet available.
Liver function monitoring is required before starting treatment and regularly thereafter.
The final draft NICE guidance is available on the NICE website.
Recent Comments