Menopausal vasomotor symptoms (VMS) represent a significant public health burden, necessitating safe and effective nonhormonal treatments.The recent US Food and Drug Administration approval of elinzanetant, a first-in-class dual neurokinin-1 (NK1) and neurokinin-3 (NK3) receptor antagonist, represents a major shift and warrants a critical assessment of its role.VMS pathogenesis centers on the hypothalamic KNDy neuron network and is primarily mediated by Neurokinin B acting on the NK3 receptor.Elinzanetant's distinctive dual mechanism, simultaneously blocking NK3 (VMS control) and NK1 (mood and sleep modulation), translates into improved patient outcomes as demonstrated across the OASIS Phase 3 program.Specifically, elinzanetant achieved a 65.2%-67.0%reduction in VMS frequency by Week 12 (OASIS 1/2) and produced clinically meaningful improvement in the PROMIS SD-SF 8b sleep disturbance score.While indirect cross-over study comparisons with fezolinetant (NK3 antagonist) suggest a numerical advantage in sleep quality for elinzanetant, head-to-head trials are required for confirmation.The drug demonstrated sustained efficacy and a favorable long-term liver safety profile, making it strategically important for the general population.Elinzanetant represents a major shift in the nonhormonal treatment approach, offering a safe and sustained alternative for managing menopausal symptoms.
Teli et al. (Thu,) studied this question.