Endometriosis: New pill Relugolix approved for NHS to treat debilitating condition

Relugolix–estradiol–norethisterone is also known as relugolix combination therapy or Ryeqo. It is a combination drug which is thought could help about 1,000 women a year.

It has been approved for NHS use by the National Institute for Health and Care Excellence (Nice), and will cost £72 a month for each person for whom it is prescribed.

What is endometriosis?

Endometriosis occurs when cells similar to those in the lining of the womb grow in other parts of the body, such as the pelvis, bladder and bowel. It can cause severe pain, heavy periods, exhaustion and fertility problems and can have a big impact on women’s lives.

It affects around 1.5 million women in the UK but, according to Nice, diagnosis typically takes nine years from when symptoms first appear. According to the NHS website, it can take a long time to diagnose endometriosis because symptoms can be similar to other conditions, such as fibroids, pelvic inflammatory disease and irritable bowel syndrome.

What is Relugolix?

The new drug is the first long-term daily pill licensed to treat the condition, and works by blocking specific hormones that contribute to endometriosis, while also providing necessary hormone replacement.

Unlike current injectable treatments which can initially worsen symptoms, the pill can be taken at home, works more quickly, combines hormones in one pill and cuts the need for visits to clinics.

Nice initially rejected the drug, but new evidence was provided by the manufacturer Gedeon Richter to address questions about effectiveness and value for money. The drug will only be made available on the NHS for patients whose medical or surgical treatment for endometriosis has failed.

What have experts said about it?

Helen Knight, director of medicines evaluation at Nice, said: “This new treatment marks a potential step-change in how we manage endometriosis, putting control back in patients’ hands while ensuring value for the taxpayer. Instead of travelling to clinics for injections, there is now a daily tablet that can be taken at home.

“The treatment can also be stopped and started more easily, which is particularly important for those planning to have children and for managing side-effects. This convenience not only benefits patients but reduces pressure on NHS services.”

The charity Endometriosis UK said it noted the drug may be suitable for only a small proportion of the 1.5 million women with the disease.

“For those with a history of previous medical or surgical treatment for their endometriosis, Relugolix CT is an alternative option if treatments such as tranexamic acid, hormonal contraceptives, and intrauterine delivery systems have not worked or are unsuitable,” it said in a statement.

“Relugolix CT is currently the only licensed GnRH antagonist option and is an alternative secondary medical option to GnRH agonists (eg Prostap & Zoladex) which are only licensed for up to six months. Relugolix CT can be taken up until menopause.”

Dr Sue Mann, NHS national clinical director for women’s health, said: “This first-of-a-kind treatment for endometriosis – a condition which can be extremely debilitating – will give women greater control of their own health by potentially allowing them to get the treatment they need in the comfort of their own homes, without the need to attend regular appointments.”