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1yr
Novel MOA targets age-old condition

Hot flashes—experienced by 70%-80% of menopausal women—are physically distressing and worsen quality of life. Newer therapies, such as NK3R antagonists, leverage a non-hormonal approach to addressing these symptoms.

For example, fezolinetant is a selective NK3R antagonist that directly blocks NKB from binding to the KNDy neuron. NKB is a known trigger of vasomotor symptoms (VMS).

KNDy neurons located at the level of the hypothalamus are inhibited by estrogen and triggered by the neuropeptide NKB, thus resulting in the regulation of body temperature.

During menopause, estrogen decline interferes with this balance involving NKB. Left unopposed, NKB signaling increases KNDy neuronal activity. This process sets off heat-dissipation mechanisms, such as vasodilation and sweating (or VMS).

Thus, fezolinetant helps decrease the frequency and intensity of hot flashes and night sweats, honing in on NK3R with an affinity 450 times higher than that of NK1 or NK2 receptors.

What are your thoughts on this new mechanism of action for the treatment of VMS?

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  • 1yr
    major benifit for a lot pf pts that do not desire hormones or pts with breast cancer. biggest problem is the q 3 month LENZ checks
  • 1yr
    non hormone treatment for post menopausal; symptoms is amazing
  • 1yr
    cost
  • 1yr
    Great product, but affordability is a huge problem even doing a PA.
  • 1yr
    I continue to receive good feedback from the patients who could get the Veozah after I prescribed it to them. Please also refer to my response from May 9th 2024
  • 1yr
    Insurance is a huge problem even with PA. Most of my patients cannot afford it. Those that do love it.
  • 1yr
    I have been following the development and now debut of NK3 antagonists for quite some time, I especially like the mechanism of action as it addresses the 'root cause' of the hot flash. I have prescribed Veozah since its availability with excellent feedback from my patients who experience quick onset of therapeutic effect, most do not mind the requirement for Liver Function Tests at commencement and then regularly thereafter. Veozah is an extremely welcome addition to our choice for treatment of VMS. The cost and access problem remains since most PBMs and third party payors require prior authorization and out of pocket co-pay is high even if it is approved/authorized. I believe many more prescriptions would be written if the prior authorization/high copay problems are addressed.
  • 1yr
    It is nice to have another non-hormonal medication options with a new MOA that is available to offer patients who are suffering from VMS
  • 1yr
    It is an intriguing new class. I am always a bit hesitant to use a new class right out of the gate since long term risks are not known.
  • 1yr
    This represents a promising non-hormonal therapeutic approach. This mechanism is distinct from hormone replacement therapy (HRT) and offers a significant advantage for women who are unable or unwilling to use HRT due to contraindications or personal preference. Recent studies and trials have confirmed the efficacy of NK3R antagonists in reducing hot flashes in postmenopausal women, with improvements observed as early as four weeks into treatment.
  • 1yr
    Treatment to improve QOL for VMS
  • 1yr
    Appears to be a safe alternative to hormones in the treatment of VMS with a unique MOA. I’d like to see more efficacy comparison studies vs. estrogen.
  • 1yr
    3 of my patients said they felt better in week one! This is exciting. I have had a few insurance denials.
  • 1yr
    It is a game changer for the management of the VMS lot of women still shy away from the HRT for the management of the VMS for more than one reasonfor the pts who can afford it and have no risk factors for any liver disease it is an excellent choice am sure more drugs focussing on this MOA will come thoough !!!
  • 1yr
    excellent alternative to hormone therapy in women who cant take hormones ,however will insurance pay for it ?
  • 1yr
    It’s very interesting to hear about this new therapy. I was not aware of it. It sounds like it will be cost prohibitive.
  • 1yr
    It is a new option for the treatment of vms symptoms,need close monitoring of liver enzymes, repeat test after 3,6,9 months of treatment.
  • 1yr
    i think it is a great option for those who cannot take estrogen (previous cancer or blood clot risk) however with that comes possibly fragile health already, screening for renal and liver disease, alcohol screening very important as this can increase risks. sometimes antidepressants are still best option for management of sleep, mood depending on the patient.
  • 1yr
    I think that we have to be selective where we use this drug. The drug cost is around $500-$600 a month and we do have to monitor hepatic functions. That being said it certainly seems to work well.
  • 1yr
    Interesting information
    It makes a lot of like an effective treatment
  • 1yr
    I think its a novel treatment non hormonal and those patients who have tried it, have found it successful

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