Efficacy and Safety of Fezolinetant and Elinzanetant for Vasomotor Symptoms in Menopausal Women

The current study evaluated the effectiveness and safety of fezolinetant and elinzanetant for treating vasomotor symptoms in menopausal women.

A systematic search of MEDLINE, EMBASE, and Cochrane databases was conducted up to August 22, 2024, focusing on randomized controlled trials (RCTs) involving fezolinetant, elinzanetant, vasomotor symptoms, and menopause. The researchers included RCTs that compared fezolinetant and elinzanetant against a placebo in menopausal women experiencing vasomotor symptoms.

The findings of the study revealed:

The analysis involved extracting data such as patient numbers, average age, and body mass index (BMI) and number of patients who underwent oophorectomy.
A total of seven RCTs with 4,087 patients were analyzed using the Mantel–Haenszel method and R 4.3.2 for statistical evaluation.
Both drugs, fezolinetant and elinzanetant, significantly reduced the frequency of vasomotor symptoms: fezolinetant at 30 mg (mean difference 2.16), 45 mg (mean difference 2.54), and elinzanetant at 120 mg (mean difference 2.99).
In addition, both these drugs also decreased vasomotor symptom severity, with similar results for each dosage.
Notably, elinzanetant at 120 mg improved sleep quality significantly (mean difference 4.65).
However, elinzanetant was also found to be associated with a higher incidence of drug-related adverse events (11.70% vs. 20.75%) and headache (2.54% vs. 8.0%).

To summarize, this meta-analysis indicated that both fezolinetant and elinzanetant are effective in alleviating vasomotor symptoms in menopausal women, with elinzanetant showing more substantial benefits by reducing symptom frequency, severity, and enhancing sleep quality compared to fezolinetant.

Source: Menegaz de Almeida A, Oliveira P, Lopes L, Leite M, Morbach V, Alves Kelly F, Barros Í, Aquino de Moraes FC, Prevedello A. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-analysis. Obstet Gynecol. 2025 Mar 1;145(3):253-261. doi: 10.1097/AOG.0000000000005812. Epub 2025 Jan 2. PMID: 39746208.

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