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A future treatment for the pain of degenerative joint disease in cats?

Gruen Me, Thomson AE, et al. A feline-specific anti-nerve growth factor antibody improves mobility in cats with degenerative joint disease-associated pain: A pilot proof of concept study. J Vet Intern Med. 2016 Jun 22.

The number of approved medications for the management and treatment of pain in cats is limited. There is no approved medication for the long-term treatment of chronic pain in cats in the United States. Because many adult and geriatric cats have radiographic evidence of degenerative joint disease and a large percentage of these cats will have associated chronic pain, there clearly is a need for a treatment for chronic pain.

There is one medication, a nonsteroidal anti-inflammatory drug (NSAID) named meloxicam, which is approved in Europe for use in treating chronic pain in cats, but the drug has not been approved for such use in the U.S. One primary concern about the chronic use of NSAIDS in cats is their potential effect on kidney function and a majority of cats exhibiting DJD-associated pain also have evidence of chronic kidney disease.

The aim of these researchers here was to evaluate a new potential therapeutic for chronic pain associated with DJD as a pilot proof of concept study. Prior research has demonstrated that neutralizing antibodies against nerve growth factor (NGF) are analgesic in rodents, naturally occurring DJD pain in dogs, and chronic pain in humans. At this time, it is appropriate to evaluate the efficacy of a fully felinized anti-NGF antibody (NV-02) for the treatment of DJD pain and mobility impairment in cats.

The study was a placebo-controlled, pilot, masked clinical study involving 34 client-owned cats with DJD-associated pain and mobility changes. The cats were randomized to receive 0.4 mg/kg SC or 0.8 mg/kg SC with a single treatment of NV-02 or a placebo which was saline. Activity was monitored objectively. Owners also completed different outcome measures (CSOM) and feline musculoskeletal pain index scores (FMPI).

The results showed an increase in activity between 2 and 6 weeks after treatment with NV-02. The duration of effect appears to be about 6 weeks. There was no evidence of allergic response to the injections of NV-02. The authors stated a comparison shows that a single injection of NV-02 produces levels of increased activity that is the same or greater than the increase in activity noted with daily administration of 0.035mg/kg meloxicam. There are no reports of renal toxicity due to anti-NGF treatment in any species, though due to the prevalence of chronic kidney disease in cats this will continue to remain a concern in cats and a continued need for monitoring for changes related to CKD.

The authors state this study appears to show that NV-02 has great promise as a treatment to alleviate the chronic pain associated with degenerative joint disease in cats. (VLT)

See also:

Gearing DP, Huebner M, et al. In vitro and in vivo characterization of a fully felinized therapeutic anti-nerve growth factor monoclonal antibody for the treatment of pain in cats. J Vet Intern. 2016 June 15.