Menopause pills eases hot flashes, night sweats

Hello Health Rounds readers! Before I tell you what studies we're featuring today, I want to share the flood of vaccine policy news. Kennedy advisers have voted to change MMRV vaccine use in children; a US Democratic Senator asked health insurers to commit to covering vaccines; northeast US states formed a health alliance in response to federal vaccine limits; West Coast states recommend COVID shots for all adults and children, breaking with federal policy; and the US vaccine panel has set up working groups to study pregnancy and childhood vaccination schedule.

In other breaking news, see these stories from our Reuters journalists: U.S. government lawyers objected to new powers for Kennedy's COVID vaccine adviser; Texas governor signs bill cracking down on mail-order abortion pills;  Democratic lawmakers urge Trump to drop plan to kill vehicle emission limits; alcohol, tobacco and food giants block health reforms; new US global health plan prioritizes drugs, recipients' self-reliance; Europe struggles with chronic drug shortages and over 30 people have died from Ebola in Congo.

Finally, below in our Study Rounds section, we highlight a trial in which a non-hormonal pill relieved hot flashes and night sweats in women going through menopause. We also report today on a startling new finding about an aggressive form of lung cancer and on an experimental drug that would be the first in a new class of antibiotics for tackling hard-to-kill superbugs.

U.S. Health Secretary Robert F Kennedy Jr. is accelerating efforts to remake the nation's vaccine policies, pushing past the objections of government scientists and lawmakers as well as mounting calls for his removal.

Menopausal hot flashes and night sweats were significantly reduced for women taking a non-hormonal pill from Bayer in a late-stage trial, researchers reported in JAMA Internal Medicine.

More than 600 postmenopausal women with troublesome vasomotor symptoms took either elinzanetant or a placebo daily for 52 weeks.

By week 12, elinzanetant recipients saw a more than 73% reduction in the frequency and severity of such events, compared to a 47% reduction in the placebo group, researchers reported.

By week 50, those in the elinzanetant group were experiencing an average of 1.4 moderate-to-severe hot flashes or night sweats per day, versus 3.5 such events per day in the placebo group.

Elinzanetant also seemed to reduce sleep disturbances and improve quality of life, but the study was not designed to fully assess those secondary benefits.

The drug had no harmful effects on the liver or bone density, the researchers determined.

Roughly 30% of women receiving elinzanetant and 15% of those in the placebo group reported treatment-related adverse events, such as headaches and sleepiness.

"This yearlong study not only confirmed the initial findings of rapid and significant reduction in the frequency and severity of hot flashes and night sweats but also provided evidence that these effects were sustained over a year, offering hope for longer-term relief," study leader Dr. JoAnn Pinkerton of the University of Virginia said in a statement.

"Elinzanetant will likely be an important addition to the armamentarium of nonhormonal pharmacologic options for treatment of vasomotor symptoms," an editorial published with the study concludes.

Elinzanetant was approved in July for use in the UK and Canada, where it is marketed as Lynkuet. The drug is still under review by the U.S. Food and Drug Administration.

Researchers have discovered an aggressive, hard-to-treat type of lung cancer can arise from an unexpected place.

For decades, it's been thought that small-cell lung cancer begins in neuroendocrine cells – specialized cells that combine the characteristics of nerve cells and hormone-producing cells.

But the lungs' basal stem cells - which have the ability to regenerate multiple lung cell types – can also give rise to these tumors, according to a report in Nature.

Small-cell lung cancers – as well as tumors arising from neuroendocrine cells in other organs – sometimes have tuft-like features that are linked to resistance to treatment and poor patient outcomes.

In experiments with genetically engineered mice and 944 samples of human tumors, the researchers discovered the tuft-like tumors were only triggered when genetic changes were introduced into basal cells – not neuroendocrine cells.

By determining that basal cells can form both tumor states, researchers can now look for ways to prevent the disease before it evades the immune system and spreads.

"This discovery reshapes our understanding of how small-cell lung cancer begins," study leader Trudy Oliver of Duke University School of Medicine said in a statement.

"We now have the tools to explore how the immune system interacts with these basal cells before they transform into aggressive cancer. That opens the door to therapies that could stop the disease before it even starts," Oliver said.

A synthetic antibiotic is showing potent activity against some of the world's most dangerous multidrug-resistant bacteria in lab experiments, according to the British scientists who created it.

The new drug, Novltex, kills superbugs on the World Health Organization's high-priority list, including methicillin-resistant Staphylococcus aureus – also known as MRSA, the researchers said in a statement.

It works at very low doses and outperforms several licensed antibiotics such as vancomycin, daptomycin, linezolid, levofloxacin, cefotaxime, they also said.

The researchers based the design of their synthetic antibiotic on teixobactin, a natural molecule used by soil bacteria to kill competing microbes, making sure it would be easy to optimize and manufacture.

Unlike traditional antibiotics, Novltex targets an essential building block of bacterial cell walls known as lipid II that does not mutate, which means the bugs won't easily become resistant, according to a report in the Journal of Medicinal Chemistry.

"Novltex is a breakthrough in our fight against antimicrobial resistance," study leader Dr. Ishwar Singh of the University of Liverpool in the UK said in a statement.

"While much more testing is required before Novltex reaches patients, our results show that durable and practical solutions to antimicrobial resistance are within reach."

This newsletter was edited by Aurora Ellis; additional reporting by Shawana Alleyne-Morris.

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