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It’s a harsh fact of life for about 75% of women who go through menopause and perimenopause: they suffer from hot flashes, night sweats and chills, which usually begin in the mid-40s. It can be a decades-long struggle with symptoms that affect a woman’s quality of life and productivity.
“It affects everything, so it’s not just your sleep, it’s your mood,” says Camille Moreno, DO, NCMP, medical director of the Midlife Women’s Health and Menopause Program at University of Utah Health. “It affects your work productivity and relationships. If you don’t feel like yourself in general, you’re not showing your best self at work or at home.”
Now, women are offered a prescription-only treatment for hot flashes and night sweats (also known as vasomotor symptoms). The non-hormonal drug Fezolintant, or Fezo, sold under the brand name Veozah, was approved by the US Food and Drug Administration in May. Mourinho thinks it will be a game changer.
“I’ve been waiting for the last four years for Veozah to be approved and hit the market, so it’s finally here,” says Moreno. “It’s really first in class, so it’s novel because we haven’t had anything approved before for moderate to severe vasomotor symptoms. It’s the same mechanism as Veozah.”
Moreno describes the unique way Veozah works on the human body as a switch. “It blocks a certain area in the brain that’s specifically associated with chemicals that help regulate body temperature,” she says. During menopause, a woman’s declining estrogen levels disrupt the balance between neurokinin 3 (NK3) and a chemical called estrogen, causing the hypothalamus, or the brain’s thermostat, to signal an increase in body temperature.
According to Moreno, Veozah is taking over. “That blocks (or turns off) the neurokinin (NK3) at the receptor, and that way it reduces hot flashes,” she says. “Therefore, women on hormone replacement therapy (HRT) or those who are not good candidates for hormone therapy can both benefit from Veozah.”
In fact, women who cannot take HRT or who are cautioned may benefit more from Veozah because it is a non-hormonal drug. “These are women with a history of estrogen-sensitive cancers like breast cancer, blood clots in the legs or lungs, and heart disease,” Moreno says.
Veoza is extremely effective for women who want to start or continue hormone therapy for some type of menopause more than a decade after their last period or after reaching their early 60s. That’s because recent studies show that after the 60s and/or a decade after menopause, “the use of estrogen increases the risk of cardiovascular events,” Moreno said. “So estrogen may increase the risk of stroke and heart attack.”
There were 12-week and then 40-week trials of Veozah involving more than 3,000 women. Moreno noted that the reported results of those studies were impressive. “Veozah women showed fewer hot flashes and night sweats on the first day of taking the drug,” she says. “Therefore, with a new method at the level of the hypothalamus, it has a faster effectiveness compared to estrogen treatment. With estrogen treatment, we say two to four weeks and in some women, even longer, up to three months. So that the patient can notice the difference.
Moreno is particularly excited about the impact of using a non-hormonal drug like Veozah on women of color. “Hispanic and African American women experience vasomotor symptoms (hot flashes and night sweats) earlier,” she says. “They experience perimenopause earlier, suffer more severe symptoms, and suffer longer.”
So far, the effectiveness of Veoza has not been compared to estrogen or HRT. There are no studies comparing it to , which is widely known to reduce the frequency of hot flashes by 75%. We also know a lot about the long-term health benefits and side effects of HRT. After Veozah has been on the market for several years, it will take more time to better understand the drug’s benefits and possible side effects.
In the study, Moreno noted that researchers found a smaller percentage of women who experienced elevated liver enzymes while using Veoza. “There’s a chance it could hurt or damage your liver,” she says. “However, it happened in a very small number of women in the study. But the drug carries a warning that if you have any liver condition, you should talk to your doctor before giving or taking Veozah. Before starting the drug and in three months, six months and nine months You should have a liver function test.
Of course, as with any prescription drug, cost is a factor, and Veoza needs to be affordable if a large number of women are going to use it. If the drug is available in pharmacies, the wholesale price for a 30-day supply will be $550. Moreno spoke to representatives of Astellas, the Japanese pharmaceutical company that makes Veoza, and promised to work on ways to lower the cost of the drug.
“They’re working with pharmacies to work with insurance coverage plans so that women don’t have to pay that bulk,” Moreno says. “And for women without insurance coverage, you can call (1-866-239-1637) for information about savings cards and coupons.”
She emphasized the importance of ensuring that all women who can use Veoza have the opportunity to do so. “Women shouldn’t have to pay hundreds of dollars for the drug, but they should get it at a lower price,” she said.
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