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Fezolinetant and elinzanetant offer benefits for menopausal vasomotor symptoms, with elinzanetant showing greater improvements in symptom reduction and sleep quality.
A study examining the effects of fezolinetant and elinzanetant on vasomotor symptoms in menopausal women has yielded encouraging results, confirming the efficacy and safety of both treatments. The study included data from 7 randomized controlled trials (RCTs), involving a total of 4,087 patients, and systematically reviewed outcomes from MEDLINE, EMBASE, and Cochrane databases, with a focus on the frequency and severity of vasomotor symptoms.
In this systematic review and meta-analysis, researchers collected data on patient numbers, average age, body mass index (BMI), and the proportion of patients who had undergone oophorectomy (surgical removal of ovaries). The analysis was executed via the Mantel-Haenszel method, with 95% confidence intervals (CIs) calculated. Heterogeneity across studies was examined via I2 statistics, and statistical calculations were performed via R version 4.3.2. The analysis found that both fezolinetant and elinzanetant markedly reduced the frequency of vasomotor symptoms when compared to placebo.
Fezolinetant doses of 30 mg and 45 mg were associated with mean differences of 2.16 and 2.54, respectively, while elinzanetant 120 mg demonstrated an even greater reduction with a mean difference of 2.99. These results were consistent across all analyzed studies, with no significant heterogeneity (I2=0%). In addition to symptom frequency, both drugs also illustrated a reduction in the severity of vasomotor symptoms. Fezolinetant 30 mg and 45 mg reduced symptom severity by 0.20 and 0.24, respectively, and elinzanetant 120 mg demonstrated a more pronounced reduction of 0.36.
Elinzanetant 120 mg was further noted to remarkably boost sleep quality, with a mean difference of 4.65, highlighting its broader benefits beyond just alleviating vasomotor symptoms. While both medications were generally well-tolerated, the analysis did reveal some differences in adverse events. Elinzanetant 120 mg was linked with fewer drug-related adverse events compared to placebo (11.70% vs. 20.75%), yielding a risk ratio (RR) of 0.57. Additionally, headache incidence was quite lower with elinzanetant (2.54% vs. 8.0%, RR 0.32), suggesting a more favorable safety profile compared to placebo. Thus, both fezolinetant and elinzanetant stand out as efficient options for tackling vasomotor symptoms in menopausal women, with elinzanetant emerging as the more potent treatment, particularly in lowering symptom frequency and improving sleep quality.
Obstetrics & Gynecology
Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-analysis
Artur Menegaz de Almeida et al.
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