Utilization of fezolinetant for the treatment of moderate-to-severe vasomotor symptoms of menopause in a real-world setting

Objective: – Fezolinetant (Veozah) was approved as a nonhormone treatment for moderate-to-severe vasomotor symptoms of menopause in May 2023, providing a novel treatment option for women with contraindications to menopausal hormone therapy. The objective of the study was to characterize the uptake and utilization of fezolinetant in a real-world setting. Methods: – We conducted a retrospective cohort study using TriNetX data, which includes 108 health care organizations and over 156 million patients. Females with an initial prescription for fezolinetant between May 1, 2023, and December 31, 2024, were included. We described baseline clinical and demographic characteristics and assessed the uptake of fezolinetant over time. Results: – Our cohort included 9, 853 women, including 1, 315 (13.3%) who were over the age of 65 and 2, 022 (20.5%) with a breast cancer diagnosis. Among the 7, 222 individuals with at least 3 months of continuous enrollment, 1, 477 (20.5%) had persistent use, defined as having a second fezolinetant prescription between 28 and 90 days of the initial fezolinetant prescription. Among persistent users, 42% received liver function testing in the 3 months after initiating fezolinetant, though regular monitoring is required after starting treatment. The total number of fezolinetant prescriptions increased over time, from 233 prescriptions between May 1 through July 31, 2023, to 1, 871 prescriptions between May 1 and July 31, 2024. Conclusions: – Our findings highlight a need for future postmarketing safety and effectiveness studies, especially among survivors of breast cancer and women 65 years and older, who were excluded from the randomized controlled trials.