New endometriosis pill approved for NHS use, but only few patients will benefit

The National Institute for Health and Care Excellence (NICE) has approved a new pill for the treatment of endometriosis, providing hope for thousands of women affected by the debilitating condition.

The pill, called relugolix–estradiol–norethisterone (also known as relugolix combination therapy or Ryeqo), is the first long-term daily pill approved for use in the UK to treat endometriosis, and it is expected to help about 1,000 patients every year.

Unlike current injectable treatments, this pill can be taken at home rather than at clinics and offers faster relief.

According to NICE, Ryeqo works by blocking specific hormones that contribute to endometriosis, while also providing necessary hormone replacement in a single daily tablet.

“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,” said Helen Knight, director of medicines evaluation at NICE.

She added that 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.

Endometriosis is a condition where tissue similar to the womb lining grows outside the uterus, causing chronic pain and fatigue. It is estimated to affect around 1.5 million women in the UK.

“Despite its widespread impact, diagnosis typically takes 9 years from when symptoms first appear,” NICE highlighted.

The new pill is recommended for patients for whom medical or surgical treatment for endometriosis has failed.

Initially, the drug was rejected, but the manufacturer, Gedeon Richter, provided additional evidence addressing concerns about the treatment's effectiveness and value for money.

While Endometriosis UK welcomed the approval of Ryeqo, it cautioned that the treatment may be suitable for “only a small proportion of the 1.5 million with the disease.”

The pill is a type of ‘medical menopause’ combined with hormone replacement therapy (HRT), and it is “not suitable for those where add-back hormonal therapy (ABT) is contraindicated,” the charity explained.

Endometriosis UK also stressed the need for more investment in research to find the cause of the disease, better management and treatment options, and one day a cure.