Understand the source comparison
Peptides for Hot Flashes — Comparison
Fezolinetant (Veozah) NK3 receptor antagonist blocking neurokinin B signaling FDA-approved (2023) after Phase 3 trials SKYLIGHT trials: 45% reduction in moderate-to-severe hot flashes vs 29% placebo at 12 weeks Only peptide-pathway therapy with regulatory appr
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- Fezolinetant (Veozah)
- NK3 receptor antagonist blocking neurokinin B signaling
- FDA-approved (2023) after Phase 3 trials
- SKYLIGHT trials: 45% reduction in moderate-to-severe hot flashes vs 29% placebo at 12 weeks
- Only peptide-pathway therapy with regulatory approval. Gold standard for evidence
- Kisspeptin-54
- GnRH pulse modulation via Kiss1 neurons in hypothalamus
- Phase 1/2. Single-dose pharmacokinetics only
- No published vasomotor symptom trials; animal models show thermoregulatory effects
- Biologically plausible but clinically unvalidated. No dosing protocols exist
- MK 677 (Ibutamoren)
- Growth hormone secretagogue increasing IGF-1 and nocturnal GH
- Phase 2 trials for body composition; no vasomotor endpoints
- No direct hot flash trials; proposed benefit is improved sleep disrupted by night sweats
- Off-label use. Indirect mechanism with no vasomotor evidence
- Thymalin
- Thymic peptide extract for immune modulation
- Eastern European trials for aging biomarkers
- No vasomotor symptom studies in any population
- No mechanistic basis for hot flash reduction
- Compounded NK3 antagonists
- Same as fezolinetant but from 503B facilities
- No independent clinical trials
- None. Mechanism borrowed from FDA-approved analog
- Lacks batch consistency and safety monitoring of approved drug