Fezolinetant, a new “miracle” drug for hot flashes during menopause, comes to Spain

There are 14,472,321 women over 40 living in Spain. At this age, the first symptoms associated with menopause may appear. The most characteristic are usually vasomotor, popularly called tides. One of the options for their relief is hormonal therapy.

Although there is an eternal debate surrounding this treatment, the truth is that it is contraindicated in some cases, such as hormone-dependent cancer, thrombosis or heart attack. Now, a new drug has just arrived in Spain hoping to become the one who finds himself in such situations.

“Clinical trials have shown not only its effectiveness, but also that it’s very fast“, assures Dr. Pluvio Coronado, President of the Spanish Association for the Study of Menopause (AEMM), in an interview with EL ESPAÑOL. Coronado believes that this approval is another example of how society and women have become more aware of menopause. “The taboo has not been completely eliminated , but we are following this path,” he notes.

(Here’s how Spain has broken the stigma of menopause: “It’s no longer one of the best-kept secrets.”)

The importance of this medicine is that it has more benefits than the alternatives available so far. “For example, for women at risk of thromboembolic disease or with a history of hormone-dependent tumors, natural treatments have been used that was less effective“explains Dr. Laura Baquedano, J.EFA of the Gynecological Service of the Miguel Servet University Hospital of Zaragoza.

“Until now, other than hormonal treatment for vasomotor symptoms, the results have not been quite as expected. especially if the hot flashes were intense“adds Dr. Maria Luisa Gomez, specialist in gynecology and obstetrics at the Vitas Aravaca University Hospital.

The effectiveness of fezolinetant (the active ingredient in the drug sold under the name Veosa) was proven after three clinical studies involving 3,000 women. The results showed that the drug reduced moderate to severe hot flashes and sweating. from the first week of admission.

No government funding

In our country, the retail price of Veosa is 74.31 euros (container of 28 tablets). Apart from requiring a prescription, it is not currently funded by the NHS. “It is not distributed because there was not enough time. Although, of course, it comes out with a selling price that it is not cheap” says Baquedano.

A former member of the board of directors of AEMM understands that its cost is not a barrier for women who want to access it: “Women who feel very bad will pay for this. unless they have any economic inconvenience.”

Coronado, for his part, believes that it costs more than 70 euros. can “create inequality”; That is, a woman with hot flashes and money will be able to get rid of them. But those who cannot afford this will have to resort to less effective non-hormonal treatments.”

Both agree that the ideal would be for it to be funded by public health funds in the near future, as is currently the case with other treatments for hot flashes. In the case of women with hormonal contraindications, one of the options offered to them publicly is the so-called selective serotonin reuptake inhibitors.

As Coronado explains, these substances have no effect on hormone receptors and can alleviate hot flashes. “What happened is they weren’t 100% effective,” he says. They were able to slightly reduce hot flashes, but did not improve quality of life. “From a scientific point of view, we recommend (referring to Veosa). But There’s not much we can do about funding.“.

This will be the first choice

The new drug, which is administered orally, is a neurokinin 3 receptor antagonist and works by blocking neurokinin B in KNDy neurons. That is, it serves to restore thermoregulatory balance, which will reduce both hot flashes and night sweats.

Although it currently has no noticeable side effects, there were concerns early in trials due to a possible link to liver problems. “Finally, It has been proven that it is not the drugs” says Coronado.

(The Eternal Menopause Taboo: “You’re considered no longer worthy because you’re not fertile”)

The decline of this drug is reminiscent of what happened at the beginning of the century with hormone therapy. In 2002, famous study Women’s Health Initiative (WHI) linked this to increased risk of cancer and other diseases. However, later studies adjusted the results, arguing that case mix may have been more related to the age of the participants.

In fact, experts consulted by this newspaper understand that, in addition to continuing to “individualise treatment”, hormonal treatment will continue to be the first line of treatment for menopause. First of all, in patients with many symptoms and early menopause.

And as experts remember, Veosa focuses on controlling vasomotor symptoms; That is, it does not treat other symptoms like hormone therapy. “This new drug, although an effective alternative, will not disrupt hormonal treatment. Let’s hope not, at least this is not the idea of ​​gynecologists,” emphasizes Baquedano.