Menopausal symptom management: Fezolinetant's varied doses provide effective relief for vasomotor symptoms in women - A metaanalysis of 3291 participant

Amal M. Elhusein, Hammad A. Fadlalmola, Huda H. Abedelwahed, Alawìa A. Elshaikh, Amel E. Banaga, Manal H.F. Alrahman, Nafesa H. Abdelgadim, Insaf H. Mohammed, Afaf A.A. Abdalla, Fatma A.M. Abdalla, Ebtihag M. Abd Allah, Nagwa I. Abbas, Abdullah D. Alhujaili, Egbal A. Almkiy, Eltayeb A. Idress, Eltayeb M. Awadalkareem, Selwa Y. Abdeldafie, Prema Balusamy, Rasha A. Mohamed, Rami S.M. Aloufi, Mohammed Habiballa, Mohammed A. Abdelmalik, Mohammed M. Alhejaili, Ibrahim A. Ibrahim, Huda K. Masaad

Abstract

Menopause represents the physiological transition when a woman's reproductive period ends associated with a variety of symptoms, including vasomotor symptoms, such as night sweats and hot flashes. This systematic review and meta-analysis aimed to assess the effectiveness and safety of oral Fezolinetant for treating vasomotor symptoms associated with menopause. Five electronic databases were searched from their inception until May 2023. Via the Cochrane risk of bias tool, two reviewers assessed the studies' quality. The primary outcomes were a decrease in VMSs frequency and severity and safety outcomes at 4 and 12 weeks. Data were extracted and then analyzed using RevMan software. This meta-analysis included six trials with a total of 3291 women that compared Fezolinetant to a placebo in the treatment of menopausal VMSs. After 4 and 12 weeks of therapy, fezolinetant at 30 mg QD or 45 mg QD substantially decreased the frequency and severity of VMSs per 24 hours compared to placebo. Fezolinetant at 90 mg BID, 30 mg QD, or 45 mg QD did not show a significant difference in the rate of treatment-emergent adverse events (TEAEs), headache, and TEAEs leading to permanent discontinuation compared to placebo. Fezolinetant proves to be a successful and well-tolerated remedy for menopausal women suffering from VMSs. Notably, the 45 mg daily dosage over 12 weeks exhibited significant efficacy. Nonetheless, extensive future trials are necessary to ascertain its long-term safety, effectiveness, and relative potency compared to alternative VMS treatments like hormone therapy. (Afr J Reprod Health 2024; 28 [3]: 99-113)

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