In a significant development for women suffering from endometriosis, the first daily tablet for the long-term treatment of the condition has been approved for use on the NHS. This new drug, known as relugolix-estradiol-norethisterone (or relugolix combination therapy, marketed as Ryeqo), could provide relief for around a thousand women annually who endure the debilitating effects of this chronic condition.
The National Institute for Health and Care Excellence (NICE) initially rejected the drug but has now recommended it for routine NHS use. This decision marks a turning point in the management of endometriosis, a condition that affects approximately 1.5 million women in the UK. Endometriosis occurs when tissue similar to the lining of the womb grows elsewhere in the body, leading to chronic pain, fatigue, and other symptoms. These cells respond to the menstrual cycle, building up, breaking down, and bleeding, but the blood has no way to escape, causing inflammation and scarring.
Despite its prevalence, affecting one in ten women and girls of reproductive age, according to the World Health Organisation, endometriosis often takes around a decade to diagnose. There is currently no known cure, but treatments can help manage symptoms. However, existing injectable treatments can initially worsen symptoms, making the approval of this new tablet a welcome alternative.
A Game-Changer in Treatment
The relugolix combination therapy offers several advantages over current treatments. It starts working faster, can be taken at home, and combines all the necessary hormones into a single pill. Additionally, when the treatment is stopped, hormone levels return to normal more quickly. Unlike injectable treatments, which require regular clinic visits, this tablet allows women to manage their condition more independently.
The drug will be available to patients for whom other medical and surgical treatments have failed. Helen Knight, director of medicines evaluation at NICE, described the treatment as a “potential step-change” in managing endometriosis. She emphasised that it puts control back into patients’ hands while ensuring value for taxpayers. “Instead of travelling to clinics for injections, there is now a daily tablet that can be taken at home,” she said. “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 also reduces pressure on NHS services.”
Empowering Patients
Dr Sue Mann, NHS national clinical director for women’s health, highlighted the significance of this “first-of-a-kind treatment.” She stated that it would give women greater control over their health by allowing them to receive treatment in the comfort of their own homes, without the need for regular appointments. This is particularly important for women managing the physical and emotional toll of endometriosis, as well as those balancing work, family, and other commitments.
The list price for the treatment is £72 for a 28-day supply (excluding VAT). While the cost may raise questions, the potential benefits—reduced NHS resource use, improved patient outcomes, and enhanced quality of life—are expected to justify the investment.
A Step Forward, But More Work Needed
While the approval of relugolix combination therapy is a significant milestone, it also underscores the need for continued research and investment in endometriosis care. Many women still face long delays in diagnosis and limited treatment options. The condition remains underfunded and under-researched, despite its profound impact on women’s lives.
For now, however, this new treatment offers hope to thousands of women who have struggled to find effective relief. As Helen Knight noted, it represents a “potential step-change” in the management of endometriosis, empowering patients and improving access to care.
For more information on endometriosis and related treatments, read:
- Like cement on my pelvis – the search for a cure for endometriosis
- 90-second treatment for heavy periods leaves some needing a hysterectomy
This breakthrough is a reminder of the importance of innovation in healthcare and the need to prioritise conditions that disproportionately affect women. With continued progress, the future for endometriosis patients looks brighter than ever.
