Emerging Evidence on NK Receptor Antagonism and Bone Health in VMS

This episode, titled "Emerging Evidence on NK Receptor Antagonism and Bone Health in VMS," features panelists examining the exploratory endpoints from the OASIS 3 trial and what they may signal about elinzanetant's potential effects beyond VMS relief. The experts discuss bone health data from the 52-week OASIS 3 study, noting that while bone density and bone turnover markers were evaluated as experimental endpoints, the findings showed no statistically significant positive or negative effect on bone. The experts agree that the absence of a negative effect means this data would not deter them from prescribing elinzanetant in a patient with mild osteopenia, but they are equally clear that it should not be relied upon as a bone-protective therapy.

For patients with osteopenia, the experts recommend continued DEXA monitoring alongside lifestyle, dietary, and supplement-based strategies. They also highlight that menopausal hormone therapy holds an FDA-approved indication for osteoporosis prevention — a fact that many patients and clinicians are unaware of — and suggest that as rapport develops and symptom burden shifts, revisiting hormonal options may be warranted for patients where fracture risk outweighs other concerns.

The conversation closes with a discussion of additional exploratory endpoints from the OASIS 3 sub-analysis, including weight, muscle mass, and fat mass, where early data suggested potentially favorable body composition trends. While not yet statistically definitive, the experts flag these findings as worth monitoring as the evidence base for NK1 receptor antagonism continues to evolve, emphasizing that staying curious and remaining open to emerging research is essential to delivering the best possible care for patients navigating menopause.

In the next episode, "Long-Term VMS Management and Key Takeaways for Clinical Practice," panelists will discuss the evolving approach to long-term VMS treatment, addressing the absence of arbitrary treatment endpoints, the importance of individualized and prevention-focused care, and closing reflections on the shifting treatment landscape and the ongoing barriers women face in accessing comprehensive menopause care.