Gruen, M. E., Myers, J., & Lascelles, B. (2021). Efficacy and Safety of an Anti-nerve Growth Factor Antibody (Frunevetmab) for the Treatment of Degenerative Joint Disease-Associated Chronic Pain in Cats: A Multisite Pilot Field Study. Frontiers in veterinary science, 8, 610028. https://doi.org/10.3389/fvets.2021.610028
Degenerative joint diseases, including osteoarthritis (OA), are increasingly recognized as a problem in cats. Studies have suggested that while 64-90% of cats have radiographic evidence of degenerative joint disease (DJD), fewer than half will show outward pain or detectable clinical signs. Affected cats could benefit greatly from treatments targeted at reducing pain and inflammation associated with DJD, and while many popular drugs, such as non-steroidal anti-inflammatories (NSAIDs) have proved efficacious over the years none have come without question or controversy. As such, there remains a critical need for analgesic options for cats with DJD. A novel therapy, Anti-Nerve Growth Factor (NGF) monoclonal antibodies (mAb), has shown to be very efficacious in human studies and a canine formulation has already been approved in Europe. This year, a feline anti-NGF mAb (frunevetmab) was approved for the control of pain associated with OA in cats.
The purpose of this study was to further evaluate safety and efficacy of frunevetmab (SolensiaⓇ). The authors evaluated different routes of administration, longer-term efficacy, and possible adverse events.
This was a multisite, randomized, double-blind, placebo-controlled study with three treatment groups each receiving two doses 28 days apart. Group 1 received frunevetmab IV followed by SC, Group 2 received frunevetmab SC followed by SC, and Group 3 received a placebo IV followed by SC. Cats were eligible if older than 6 months, weighed more than 2.5kg, were indoors-only, and were in generally good health or had stable chronic conditions. All had clinical and radiographic signs of DJD.
The outcomes measured for efficacy were changes in owner assessment of pain/mobility, objective measurements of activity via a collar-fitted accelerometer, and veterinary orthopedic exams. Adverse events for all three groups were recorded.
Owner questionnaire results suggested a significant improvement in mobility and quality of life in frunevetmab-treated cats over time, regardless of the route of administration. Treatments were generally well-tolerated, and the majority of adverse events were skin-related from the accelerometer collars, although mild digestive issues were also noted.
Like many veterinary studies, this one had a limited sample size of 126 cats, but statistical analysis was adjusted accordingly. Owner interpretations of pain in cats can be subjective, as can veterinary orthopedic exams. While the accelerometry data showed a difference between the treatment and control groups, all three groups had an overall decrease in activity, suggesting either resistance to the collars or an inaccurate baseline measurement at the start.
The results of this study support the use of frunevetmab for the treatment of chronic pain in cats. This injectable therapy would preclude the need to pill cats, which can be difficult and put stress on both owner and cat. ~SdW
Keizer, R. J., Huitema, A. D., Schellens, J. H., & Beijnen, J. H. (2010). Clinical pharmacokinetics of therapeutic monoclonal antibodies. Clinical pharmacokinetics, 49(8), 493–507. https://doi.org/10.2165/11531280-000000000-00000
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Osteoarthritis, DJD, Monoclonal antibody, mobility