Canine osteoarthritis (OA) is undeniably common, with studies reporting nearly 40% of dogs showing signs of the disease. However, it’s not always diagnosed or treated; in fact, it’s estimated that only a third of the dogs experiencing OA receive treatment, according to Zoetis.

“Osteoarthritis can be an insidious disease; the signs are often overlooked as aging and get worse over time,” said Sharon L. Campbell, DVM, MS, DACVIM, medical affairs lead, canine chronic pain, at Zoetis. Plus, although OA can affect dogs as early as their first birthday, it’s long been thought of as a senior dog disease, so it’s not always considered a possibility for young dogs.

That’s a huge problem, because not only does a missed diagnosis and lack of treatment impact the dog’s wellbeing, but it also affects the bond between these pets and their people. When the dog can’t continue participating in activities that foster the human-animal bond, like playing catch or going for a walk, or when they begin to hide or show aggressive behavior due to their pain, it causes a break in that bond, said Campbell.

This bond is one of the reasons why the FDA’s recent approval of Zoetis’ latest monoclonal antibody treatment, Librela—a monthly injectable for canine OA pain—has so many metaphorical tails wagging.

“Librela can help restore the human-animal bond by getting these dogs with OA pain back to playing again,” Campbell said. “This is something that obviously benefits the dog, the owner—and is even appreciated by the veterinarian.”

Librela: Big in Europe and coming our way

Like Solensia, Zoetis’ monthly monoclonal antibody injection for feline OA pain that received FDA approval in January 2022, Librela provides an alternative to NSAIDs, controlling canine OA pain by targeting nerve growth factor (NGF). While it’s brand new to the US market, the product has been used by veterinarians in Europe for more than two years, who’ve distributed over 4.6 million doses. And the results have been largely positive—vets in Europe gave the treatment an overall satisfaction rating of 8.6 out of 10, which was the highest rating of any OA pain medication they evaluated.

The treatment is expected to become available to US-based veterinarians in late 2023, and that’s not the only welcome news. “Dogs in any stage of OA can be administered Librela,” Campbell said, which means dogs can begin to receive treatment at the very first signs of OA pain. “[I]n a recent study evaluating Librela use in Europe, veterinarians are using Librela 51% of the time in severe disease, 36% in moderate, and 13% in mild disease,” she said.

Additionally, there are no weight restrictions, so even the smallest patients can benefit, so long as they’re at least one year old; Librela has not been evaluated in dogs younger than that.

Response to treatment will vary for individual patients, Campbell said, but in the EU clinical study, dogs were treated for as long as nine months and maintained a response to therapy during that time. Those dogs ranged in severity of disease based on three components (general musculoskeletal condition, lameness/weight bearing, and pain on palpation/manipulation of the joint), but each dog had to have a severity score of moderate in at least one of those components to participate in the study.

Although a purposeful drug break is not recommended, a missed dose is not a disaster. “If a dog missed one or more doses of Librela, it is likely that that dog will experience a relapse in OA pain,” Campbell said. “However, restarting the Librela should result in as good or nearly as good of a response as before.”

Considerations for using Librela

It’s important to note that, at this time, Librela has only been evaluated in dogs with OA in the joints of the limbs; it has not been evaluated in dogs with OA of the spine. It should not be used in breeding dogs or dogs who are pregnant or lactating, and it should be avoided with any dog with a known hypersensitivity to bedinvetmab. The most common adverse events reported included urinary tract infections, bacterial skin infections, dermatitis, and increased blood urea nitrogen.

These injections should be administered by a veterinary professional, but there are some risks to humans giving those injections as well; people who are pregnant, trying to conceive, or breastfeeding should take particular care to avoid self-injection, as hypersensitivity reactions like anaphylaxis could potentially occur.

Still, the availability of an effective, non-NSAID monthly treatment for canine OA pain is an exciting advance for everyone who cares about improving quality of life for dogs, owners, and veterinary professionals, alike.

Photo credit: © smrm1977  E+ via Getty Images Plus  

Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors.