非索内酯:治疗中度至重度更年期血管运动症状的潜在疗法。

TouchREVIEWS in endocrinology Pub Date : 2023-11-01 Epub Date: 2023-06-15 DOI:10.17925/EE.2023.19.2.13
Barbara DePree
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引用次数: 0

摘要

更年期最常见的症状是血管运动症状(VMS),80% 以上的绝经后妇女都会出现这种症状。此外,更年期血管运动症状也是妇女最常寻求治疗的更年期表现,即解决她们受到影响的生活质量,包括睡眠、工作和非工作相关的工作效率。更年期综合症的频率、强度和持续时间各不相同。激素疗法(HT)一直是我们治疗VMS最有效的方法,并已被美国食品药品管理局(FDA)批准用于这一适应症。尽管激素治疗是一种安全有效的治疗方法,但许多患者和医疗服务提供者对激素治疗犹豫不决。此外,高催乳素对某些女性来说是禁忌症。虽然有许多非处方和非 HT 方案,但我们缺乏大多数方案的有效性和安全性数据。这给女性留下了空白。美国食品及药物管理局(FDA)最近批准了用于治疗中度至重度 VMS 的非索内酯(Fezolinetant)。到目前为止,临床试验在安全性和有效性方面都取得了积极的成果。Fezolinetant 是一种非激素类神经激肽 3 受体拮抗剂,作用于下丘脑的体温调节中枢。阻断非激素类神经激肽 3 受体拮抗剂可调节潮热和盗汗。在开始服用非佐林内酯 4 周后,妇女每天出现的 VMS 的严重程度和频率都有了统计学意义上的显著降低,从而提高了生活质量。
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Fezolinetant: A Potential Treatment for Moderate to Severe Vasomotor Symptoms of Menopause.

The most common symptom of menopause is vasomotor symptoms (VMS), which occur in more than 80% of postmenopausal women. Furthermore, VMS are the manifestation of menopause for which women most commonly seek treatment, namely, to address their impacted quality of life, including sleep, and work-and non-work-related productivity. VMS vary in frequency, intensity and duration. Hormone therapy (HT) has been our most effective treatment for VMS and has been approved for this indication by the United States Food and Drug Administration (FDA). Despite being a safe and effective treatment option, many patients and providers are hesitant to consider HT. Moreover, HT is contraindicated for some women. While many over-the-counter and non-HT options are available, we lack data on the efficacy and safety of most of these. This has left a void for women. Fezolinetant was recently approved by the FDA for the treatment of moderate-to-severe VMS. So far, clinical trials have shown positive results in terms of safety and efficacy. Fezolinetant is a non-hormonal, neurokinin 3 receptor antagonist that works in the hypothalamus at the thermoregulatory centre. Blocking the non-hormonal neurokinin 3 receptor antagonist modulates hot flashes and night sweats. As early as 4 weeks from initiating fezolinetant, women experienced a statistically significant reduction of both severity and frequency of VMS per day, resulting in an improved quality of life.

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