Overview
- Final draft guidance endorses fezolinetant 45 mg once daily for moderate to severe vasomotor symptoms when HRT is unsuitable, with NICE estimating around 500,000 potential beneficiaries.
- Fezolinetant (Veoza) is a neurokinin‑3 receptor antagonist that targets central thermoregulatory pathways to reduce hot flushes and night sweats.
- NICE requires baseline and periodic liver‑function testing and excludes use in current oestrogen‑dependent cancers or liver disease, with additional contraindications including cirrhosis, significant renal impairment, and certain CYP450 inhibitor co‑medication.
- The recommendation draws on the DAYLIGHT and SKYLIGHT 1/2 randomized trials showing symptom reductions versus placebo, while noting uncertainty about the precise effect size due to handling of missing data.
- The committee found the drug cost‑effective for NHS use, with a list price of £44.80 per 28‑tablet pack, and implementation now moves to local formularies and care pathways.