Yesterday was a really exciting day for me! I used a totally new pain killer for arthritis for the first time at Anderson Moores Veterinary Specialists where I run a pain management clinic.
Librela (bedinvetmab) is a monoclonal antibody which targets nerve growth factor (NGF). In arthritis, NGF acts to sensitise nociceptors, leading to both peripheral and central sensitisation. The role of NGF is reviewed here in this free to access paper and also explained in our webinar.
Before I go any further, the intended audience for Zero Pain Philosophy is veterinary professionals. As vets we are not allowed to advertise any particular product directly to pet owners. If you are a pet owner, please speak to your vet about arthritis in your dog. If you would like a referral to my pain clinic then please ask your vet. I would be happy to see you!
The intention with Librela is that it replaces the need for NSAIDs in dogs. Now clearly a number of dogs respond very well to NSAIDs and these drugs are effective for mild to moderate OA. When do you add something else in? There's more information on this topic here. But some dogs respond adversely to NSAIDs. These cases should be perfect for Librela. Right now there is very little data on this and our experience over the coming months will help to form opinion on this. Encouragingly, there were minimal adverse effects in the clinical and field trials, giving us confidence in the product.
In clinical trials Librela was proven to be effective in a range of arthritis severity and could very well replace NSAIDs as a first line option. Pain was assessed using the Canine Brief Pain Inventory - which scores pain severity score and pain interference score - and also asks owner to rate their dog's quality of life. If you are not already using pain scoring for your arthritis cases then I would encourage you to do so. It certainly helps me to objectify outcomes in case management. You can read more about pain scoring here.
Librela is a monthly injection which makes life easy to say the least! No more forgetting to give the tablets or trying to work out who gave the last dose! Administration is subcutaneous with a volume of 1ml. Various product concentrations exist to suit a range of dogs from 5kg upwards. (The 5mg dose can be used at 0.1ml/kg for <5kg). The license covers dogs > 12 months of age.
Over the coming months I am keen to gain experience with clinical use of Librela and will keep you posted. It's a huge step forwards for OA management in dogs.
For an explanation of the role of NGF in pain and a review of the literature, please watch our webinar.
This post was written by Matt Gurney.
Matt sees referrals in the pain clinic at Anderson Moores Veterinary Specialists. You can also receive telemedicine advice from us here if you have a pain case where you need a helping hand.
Matt & Carl established Zero Pain Philosophy to provide educational resources & telemedicine to veterinary professionals enabling optimal management of pain.
Matt Gurney is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and works at Anderson Moores Veterinary Specialists. Matt is President of the European College of Veterinary Anaesthesia & Analgesia.
Carl Bradbrook is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and is President of the Association of Veterinary Anaesthetists. Carl works at Anderson Moores Veterinary Specialists.