New Canine Arthritis Drug
What is the new drug that veterinarians are giving to dogs with osteoarthritis?
Librela is the brand name of the monthly injectable medication prescribed for dogs suffering with pain from osteoarthritis. This is a condition where the cartilage, which is the protective material that cushions a joint between two bones, breaks down over time, causing the bones to rub against each other. This rubbing can permanently damage the joint and cause pain, inflammation and lameness.
The generic name for Librela is bedinvetmab, which indicates it is a monoclonal antibody (mAb). Librela is the first and only injectable anti-nerve growth factor (NGF) monoclonal antibody produced to control arthritis pain in dogs.
It works by reducing NGF effects, which is a key factor in osteoarthritis pain. By binding to NGF, Librela helps to reduce canine osteoarthritis pain and the associated inflammation.
What is nerve growth factor?
Nerve growth factor, or NGF, is a signaling protein that is produced by injured tissues. NGF is necessary for the development of the nervous system in animals during growth, but once the nervous system is fully developed in an adult animal, NGF takes on a different function. It plays an important part in starting and continuing pain. Compared with healthy joints, dogs with arthritis have elevated NGF in the synovial fluid in their affected joints.
Is Librela safe?
Studies have shown Librela to be safe and effective. It functions like naturally produced antibodies and is eliminated through normal protein degradation pathways with minimal metabolism by the liver or kidneys.
In clinical trials, adverse reactions were similar to what would be expected for the population of dogs with osteoarthritis. The most common side effects reported in Librela-treated dogs were urinary-tract infection, bacterial skin infection, dermatitis and elevated blood urea nitrogen (BUN). For the vast majority of dogs, an increase in BUN was not associated with signs of kidney disease or changes in other kidney values.
Librela is intended for use in dogs with osteoarthritis. This is generally an older population of dogs, so Librela should not be administered to breeding, pregnant or nursing dogs, or dogs with hypersensitivity or known allergy to bedinvetmab. The safety and effectiveness of Librela have not been evaluated in dogs under 12 months of age.
Which dogs would be good candidates for Librela?
Librela is specifically designed for long-term management of arthritis pain in dogs. It can be used in dogs that are 12 months of age or older. It is especially recommended for dogs whose owners are unable to administer daily oral medication. Dogs that do not tolerate oral pain medications or whose kidney and liver function will not support oral pain medications are good candidates for Librela.
How effective is Librela?
In multiple field studies, dogs that were given Librela as a monthly injection showed a decrease in pain related to osteoarthritis compared with dogs that received the placebo. Librela was shown to improve their mobility and overall quality of life.
How long does it take for it to work?
While effectiveness may not be seen until after the second dose of Librela, some dogs may experience a reduction in pain as early as seven days after the first dose. In a prolonged clinical study, dogs treated with Librela experienced lasting arthritis pain relief over the course of the study with monthly injections.
Can Librela be used with NSAIDs?
NSAIDs are non-steroidal anti-inflammatory medications that are commonly prescribed to treat pain due to osteoarthritis. Some products are Rimadyl, Deramax, Previcox, Galliprant and Meloxicam. NSAIDS reduce pain and inflammation by affecting substances that the body releases after cells are damaged.
Some medications block COX enzymes and some medications block the activity of prostaglandins. These substances contribute to pain and inflammation, but they have positive functions, too. These include protecting the lining of the stomach and intestines, maintaining blood flow to the kidneys and supporting platelet clotting function.
Because NSAIDs interfere with cox enzymes and prostaglandins, the drugs can cause gastrointestinal, kidney and liver side effects. Some of the most common side effects in dogs are vomiting, decreased appetite, lethargy and diarrhea. Dogs that experience these side effects should stop taking the NSAIDs and may be good candidates for Librela injections.
At this time, there is not sufficient data regarding the safety of concurrent use of both Librela and daily NSAIDS.
Can Librela be used with other commonly used medications?
As part of the product testing, Librela was given with commonly prescribed medications, including antibiotics and worming drugs. There were no adverse drug interactions. Dogs also received vaccinations at the same time Librela was administered and no reactions were noted.
Can dog owners give Librela at home?
Librela is a monthly injection only available by prescription from a licensed veterinarian because professional expertise is required to properly diagnose osteoarthritis pain in dogs, administer the injection, look for concurrent problems, ensure proper administration and storage, and monitor the safe use of the product, including treatment of adverse reactions.
Are the reports of bad reactions to Librela on social media true?
It seems that whenever a new product comes on the market, along with praise for its effectiveness also come reports of product failures and reactions. Veterinarians as a profession tend to be conservative when embracing new technology. Most adopt a “wait and see” attitude before prescribing.
Looking through reviews of Librela, I found few substantiated reports of serious adverse reactions. The most commonly reported was swelling or inflammation at the site of the injection. Increased thirst and urination were reported in a small number of dogs. There were occasional reports of decreased appetite and rear-leg weakness. Hypersensitivity reactions such as a swollen face and itching were extremely rare.
This is a drug prescribed for dogs with chronic painful joint disease. Some symptoms that may be blamed as a side effect of the drug may actually be a manifestation of the dog’s primary disease.
I think this new type of treatment may be a game changer for many dogs and owners. It frees them from having to give daily medication that may cause damage to vital organs over time. Hopefully, more information about this drug and its usefulness will continue to be gathered now that it is more widely prescribed.