Fezolinetant and Vascular Health and Brain Health (FAVES-B)

The goal of this clinical trial is to learn whether a study drug called fezolinetant impacts cardiovascular and cognitive health in women who have moderate to severe menopausal hot flashes and night sweats.

Researchers will compare fezolinetant to a placebo. A placebo is a pill that looks like the study drug but does not contain any active medicine. This comparison helps researchers understand whether fezolinetant works better than no treatment.

Participants will:

Be randomly assigned to take either fezolinetant (45 mg) or a placebo once a day for 12 weeks.

Visit the research clinic for regular checkups and tests during the study. Complete tests that measure blood vessel function and cognition.

Participants and study staff will not know which treatment each participant receives during the study.

Study Overview

• Status: Not yet recruiting
• Conditions: Menopause Hot Flashes
• Intervention / Treatment: Drug: Placebo; Drug: Fezolinetant

Detailed Description

Double-blind, placebo-controlled randomized trial to determine whether 12 weeks of 45 mg of fezolinetant, a non-hormonal treatment for hot flashes associated with menopause, improves vascular and brain health in participants with moderate to severe menopausal hot flashes. Participants will be randomized to either 12 weeks of fezolinetant 45 mg or placebo. Primary endpoints include change from baseline in endothelial function and verbal memory.

• Study Type: Interventional
• Enrollment (Estimated): 220
• Phase: Phase 3

Contacts and Locations

• Study Contact: Name: Sarah M Conklin, PhD; Phone Number: 878-261-6899; Email: conklinsm2@upmc.edu
• Study Contact Backup: Name: Mollie B Bandy, BA; Phone Number: 412-648-9088; Email: BandyMB@upmc.edu

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60612
      • University of Illinois, Chicago
      • Contact: Ece K Weishaar, MS; Phone Number: 312-996-1623; Email: EceKilic@UIC.Edu
      • Sub-Investigator: Pauline M Maki, PhD
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15260
      • University of Pittsburgh
      • Contact: Sarah M Conklin, PhD; Phone Number: 8782616899; Email: conklinsm2@upmc.edu
      • Contact: Mollie B Bandy, BA; Phone Number: 8782616899; Email: BANDYMB@upmc.edu
      • Principal Investigator: Rebecca C Thurston, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Born female
• Age ≥40 - ≤65 years at the time of the screening visit
• Body Mass Index (BMI) ≥18 to ≤38 kg/m2
• Seeking treatment or relief for moderate to severe VMS associated with menopause
• Confirmed menopausal as per one of the following criteria at the time of screening: Reporting spontaneous amenorrhea for ≥12 consecutive months; spontaneous amenorrhea for ≥6 and < 12 months with follicle-stimulating hormone >40 IU/L
• Negative urine pregnancy test at screening (if <12 months of amenorrhea)
• A minimum average of 7-8 moderate to severe VMS per day, or 50-60 per week prior to randomization as reported in the 7-day hot flash diary
• Agrees to not participate in another interventional study (pharmaceutical or device) while participating in this current study

Exclusion Criteria:

• Pregnancy/lactation (past 6 months)
• Any treatment for hot flashes with demonstrated efficacy for hot flashes
• Currently using systemic sex-hormone medications.
• Currently using cytochrome P450 1A2 (CYP1A2) inhibitors (as listed according to the FDA).
• Severely elevated blood pressure [systolic blood pressure (SBP) >180 and/or diastolic blood pressure (DBP) >110]
• A medical condition or chronic disease (including history of hepatic, renal, cardiovascular, gastrointestinal, pulmonary [e.g., moderate asthma], endocrine or gynecological disease) or malignancy that could confound interpretation of the study in the opinion of the investigator or study physician
• Self-reported narcolepsy
• Previous/current history of a malignant tumor, except for basal cell carcinoma
• Participants with known cirrhosis, active liver disease, jaundice, or elevated liver aminotransferases or total bilirubin (ALT, AST, and total bilirubin), should not be enrolled if ALT or AST is ≥ 2 x ULN or if the total bilirubin is ≥ 2 x ULN for the evaluating laboratory. Participants with ALP > 1.5 × ULN and judged clinically significant by the study physician.
• Severe renal impairment [estimated glomerular filtration rate (eGFR) 15 to <30 mL/min per 1.73 m2] or end-stage renal disease (ESRD) (eGFR < 15 mL/min/1.73 m2) at screening as per USPI
• Positive Hepatitis C virus antibody, Hepatitis B surface antigen, and/or human immunodeficiency virus antibody screen at screening
• History within the last 6 months of undiagnosed uterine bleeding
• Key medical conditions (history of cardiovascular disease, stroke/cerebrovascular accident, brain injury with loss of consciousness for more than 60 seconds within the last five years, cognitive disorders, brain tumor, dementia, Parkinson's disease, chemotherapy, psychotic disorders)
• Metal in the body, claustrophobia, or cannot undergo 3T magnetic resonance imaging (MRI); Inability to meet MRI eligibility criteria
• Lymph node removal on both sides of the body, mastectomy, or dialysis
• Hysterectomy; levonorgestrel-releasing intrauterine systems initiated before 12 months of spontaneous amenorrhea (Not exclusionary if placed after 12 months of spontaneous amenorrhea), or history of endometrial ablation will be excluded due to inability to stage menopause; Bilateral oophorectomy if completed prior to 12 months of spontaneous amenorrhea
• Cardiovascular medication use.
• Prior exposure to fezolinetant or elinzanetant
• Current participation in another interventional study or participated in an interventional study or received any investigational drug within 3 months
• Illicit substance use reported in the past week or detected by urine toxicology screen.
• Subject has any condition, which in the investigator's or study physician's opinion, makes the subject unsuitable for study participation.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo Arm; The placebo tablet will be an identical tablet appearing to active medication. The placebo tablets contain the following inactive ingredients: ferric oxide, hydroxypropyl cellulose, hypromellose, low-substituted hydroxypropyl cellulose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide.	Drug: Placebo; The placebo tablet will be an identical tablet appearing to active medication. The placebo tablets contain the following inactive ingredients: ferric oxide, hydroxypropyl cellulose, hypromellose, low-substituted hydroxypropyl cellulose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide).
Experimental: Active Study Drug; Fezolinetant is a white powder. It is very slightly soluble in water (0.29 mg/mL). Fezolinetant tablets that will be used in this study are round, light red film-coated tablets with no marking on the tablets. Each fezolinetant tablet for oral use contains 45 mg of fezolinetant and the following inactive ingredients: ferric oxide, hydroxypropyl cellulose, hypromellose, low-substituted hydroxypropyl cellulose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide.	Drug: Fezolinetant; Fezolinetant is a white powder. It is very slightly soluble in water (0.29 mg/mL). Fezolinetant tablets that will be used in this study are round, light red film-coated tablets with no marking on the tablets. Each fezolinetant tablet for oral use contains 45 mg of fezolinetant and the following inactive ingredients: ferric oxide, hydroxypropyl cellulose, hypromellose, low-substituted hydroxypropyl cellulose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Flow-Mediated Dilation	Endothelial function assessed by flow-mediated dilation	Baseline and end of treatment at 12 weeks.
Verbal Memory Performance	Verbal memory neuropsychological test performance	Baseline and end of treatment at 12 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Endothelial Biomarkers	Blood-based endothelial function biomarkers	Baseline and end of treatment at 12 weeks.
Brain Activation during Verbal Encoding	Memory circuitry as measured by changes in brain activation during performance of a functional magnetic resonance imaging (fMRI) task of verbal encoding	Baseline and end of treatment at 12 weeks.
Functional Connectivity during recall	Memory circuitry as measured by changes in functional connectivity during performance of a functional magnetic resonance imaging (fMRI) task of verbal recall	Baseline and end of treatment at 12 weeks.
Subjective Vasomotor Hot Flash Diary	frequency of subjectively assessed VMS using a digital hot flash diary	Baseline and end of treatment at 12 weeks.
Objective Vasomotor Monitoring	Frequency of objectively measured VMS using 24-hour skin conductance monitoring	Baseline and end of treatment at 12 weeks.
Sleep Monitoring	Objective sleep monitoring.	Baseline and end of treatment at 12 weeks.

Collaborators and Investigators

• Sponsor: Rebecca Thurston
• Collaborators: Astellas Pharma Global Development, Inc.
• Investigators: Principal Investigator: Rebecca C Thurston, PhD, University of Pittsburgh

Study record dates

Study Major Dates

• Study Start (Estimated): September 25, 2026
• Primary Completion (Estimated): November 30, 2029
• Study Completion (Estimated): December 30, 2029

Study Registration Dates

• First Submitted: May 18, 2026
• First Submitted That Met QC Criteria: May 18, 2026
• First Posted (Actual): May 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: menopause; cognition; women's health; hot flashes; brain health; vascular health
• Additional Relevant MeSH Terms: Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hot Flashes; fezolinetant
• Other Study ID Numbers: STUDY25120039

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No