Efficacy and safety of GS1-144, a novel neurokinin 3 receptor antagonist, for moderate-to-severe vasomotor symptoms associated with menopause in Chinese women: a randomized, double-blind, placebo-controlled phase 2 trial

OBJECTIVE: This multicenter, randomised, double-blind, placebo-controlled, phase 2 trial investigated the efficacy and safety of the selective neurokinin 3 receptor (NK3R) antagonist GS1-144 for moderate-to-severe vasomotor symptoms (VMS). METHODS: Eligible participants aged between 40 and 64 years randomly (1:1:1:1) received GS1-144 30 mg once daily (QD), 60 mg QD, or 30 mg twice daily (BID) and placebo for 12 weeks. Co-primary endpoints were the mean change in the frequency and severity of moderate-to-severe VMS from baseline to weeks 4 and 12. RESULTS: Among 276 randomized participants, 271 (98.2%) and 258 (93.5%) completed 4 and 12 weeks of treatment, respectively. VMS frequency was significantly reduced versus placebo for GS1-144 30 mg BID at week 4 (difference in change in least squares mean -1.31 [90% CI: -2.35 to -0.26], P=0.04) and week 12 (-1.41 [-2.28 to -0.54], P=0.008), and for GS1-144 60 mg QD at week 12 (-1.42 [-2.28 to 0.55], P=0.007). GS1-144 30 mg BID and 60 mg QD significantly reduced VMS severity versus placebo at week 4 (-0.14 [-0.26 to -0.01], P=0.07; -0.13 [-0.26 to -0.01], P=0.07) and week 12 (-0.24 [-0.43 to -0.05], P=0.04; -0.19 [-0.38 to 0.00], P=0.098). Treatment-emergent adverse events occurred in 67.6% (140/207) of participants who received GS1-144 and 62.3% (43/69) in the placebo group. No liver safety risks were observed with GS1-144. CONCLUSIONS: GS1-144 is well tolerated and significantly reduces VMS frequency and severity in postmenopausal Chinese women.