Fezolinetant (Veoza) was approved by the FDA in 2023 for vasomotor symptoms of menopause. Its mechanism of action is:
- A Selective neurokinin-3 (NK3) receptor antagonist blocking kisspeptin-neurokinin B-dynorphin (KNDy) neuron signalling in the hypothalamus ✓
- B Selective oestrogen receptor modulator (SERM) acting at hypothalamic oestrogen receptors
- C Progesterone receptor agonist reducing FSH secretion
- D GnRH antagonist reducing pulsatile LH release
Correct answer: A. Selective neurokinin-3 (NK3) receptor antagonist blocking kisspeptin-neurokinin B-dynorphin (KNDy) neuron signalling in the hypothalamus
Explanation
Fezolinetant is a first-in-class selective neurokinin-3 (NK3) receptor antagonist. In the thermoregulatory pathway, hypothalamic KNDy neurons co-express kisspeptin, neurokinin B, and dynorphin; NKB released by KNDy neurons acts on NK3 receptors in the median preoptic nucleus to trigger vasomotor episodes. Blocking NK3 receptors reduces hot flash frequency and severity without hormonal action, making fezolinetant a non-hormonal option. It has no effect on oestrogen receptors and does not alter bone density or increase breast cancer risk.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.