Evidence collection10 September 2025

Anti-nerve growth factor monoclonal antibodies – What is the evidence?

Evidence-based veterinary medicineSmall animalsMedicine

Background

The introduction of species-specific monoclonal antibodies (mab) targeting nerve growth factor to the veterinary market (Bedinvetmab- product name Librela and Frunevetmab- product name Solensia) has provided a novel approach to the management of pain associated with osteoarthritis. However, effective management of pain and arthritis often benefits from multimodal treatment.

Monteiro, B.P. et al. (2023), 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. Journal of Small Animal Practice, 64 (4), pp. 177-254. https://doi.org/10.1111/jsap.13566
Gruen, M.E. et al. (2022) 2022 AAHA pain management guidelines for dogs and cats. Journal of the American Animal Hospital Association, 58 (2), pp. 55-76. https://doi.org/10.5326/JAAHA-MS-7292
Steagull, P.V. et al. (2021 ) 2022 ISFM consensus guidelines on the management of acute pain in cats. Journal of Feline Medicine and Surgery, 24 (1), pp. 4-30. https://doi.org/10.1177/1098612X211066268
Cachon, T. et al. (2023) COAST Development Group’s international consensus guidelines for the treatment of canine osteoarthritis. Frontiers in Veterinary Science, 10. https://doi.org/10.3389/fvets.2023.1137888

This evidence collection will bring together key references from the published evidence relating to the safety and efficacy of these products to enable you to discuss the options with your clients and support informed decision making. The first section will provide links to a small number of papers to provide background information on monoclonal antibodies and nerve growth factor. This will be followed by sections presenting published evidence on efficacy and safety alongside further information that may help you to understand this evidence in context.

Background information on monoclonal antibodies and nerve growth factor.

Wang, J. et al. (2025) Current review of monoclonal antibody therapeutics in small animal medicine. Animals, 15 (4), pp. 472. https://doi.org/10.3390/ani15040472
Enomoto, M. et al. (2019) Anti‐nerve growth factor monoclonal antibodies for the control of pain in dogs and cats. Veterinary Record, 184 (1), pp. 23. https://doi.org/10.1136/vr.104590
Chang, D. S. et al. (2016). Anti-nerve growth factor in pain management: current evidence. Journal of Pain Research, 9, pp. 373–383. https://doi.org/10.2147/JPR.S89061

Efficacy

Canine

Webster, R.P., Anderson, G.I. and Gearing, D.P. (2014) Canine Brief Pain Inventory scores for dogs with osteoarthritis before and after administration of a monoclonal antibody against nerve growth factor. American Journal of Veterinary Research, 75 (6), pp. 532-535. https://doi.org/10.2460/ajvr.75.6.532
Lascelles, B.D.X. et al. (2015) A canine-specific anti-nerve growth factor antibody alleviates pain and improves mobility and function in dogs with degenerative joint disease-associated pain. BMC Veterinary Research, 11, no. 101. https://doi.org/10.1186/s12917-015-0413-x
Corral, M.J. et al. (2021) A prospective, randomized, blinded, placebo-controlled multisite clinical study of bedinvetmab, a canine monoclonal antibody targeting nerve growth factor, in dogs with osteoarthritis. Veterinary Anaesthesia and Analgesia, 48 (6), pp. 943-955. https://doi.org/10.1016/j.vaa.2021.08.001
A journal watch summary of this article is available.
Krautmann, M. et al. (2021) Laboratory safety evaluation of bedinvetmab, a canine anti-nerve growth factor monoclonal antibody, in dogs. The Veterinary Journal, 276, 105733. https://doi.org/10.1016/j.tvjl.2021.105733.
A journal watch summary of this article is available.

Michels, G.M. et al. (2023) A prospective, randomized, double-blind, placebo-controlled multisite, parallel-group field study in dogs with osteoarthritis conducted in the United States of America evaluating bedinvetmab, a canine anti-nerve growth factor monoclonal antibody. Veterinary Anaesthesia and Analgesia, 50 (5), pp. 446-458. https://doi.org/10.1016/j.vaa.2023.06.003
Innes, J.F. et al. (2025) A randomised, parallel-group clinical trial comparing bedinvetmab to meloxicam for the management of canine osteoarthritis. Frontiers in Veterinary Science, 12, 1502218. https://doi.org/10.3389/fvets.2025.1502218
Gildea, E. et al. (2024) Use of Bedinvetmab (Librela®) for canine osteoarthritis in France, Germany, Italy, Spain, and the UK: Quantitative analysis of veterinarian satisfaction and real-world treatment patterns. Animals, 14 (15), 2231. https://doi.org/10.3390/ani14152231
Reid, J. et al (2024) Measuring the effect of the anti-nerve growth factor antibodies bedinvetmab and frunevetmab on quality of life in dogs and cats with osteoarthritis using a validated health-related quality of life outcome measure: an observational real-world study. Frontiers in Veterinary Science, 11, 1395360. https://doi.org/10.3389/fvets.2024.1395360

Feline

Gruen, M.E. et al. (2016) A feline‐specific anti‐nerve growth factor antibody improves mobility in cats with degenerative joint disease–associated pain: A pilot proof of concept study.Journal of Veterinary Internal Medicine, 30 (4), pp. 1138-1148. https://doi.org/10.1111/jvim.13972
Gruen, M.E. et al. (2021) Frunevetmab, a felinized anti‐nerve growth factor monoclonal antibody, for the treatment of pain from osteoarthritis in cats.Journal of Veterinary Internal Medicine, 35 (6), pp.2752-2762. https://doi.org/10.1111/jvim.16291
Gruen, M.E., Myers, J.A. and Lascelles, B.D.X. (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
A journal watch summary of this article is available.

Reid, J. et al (2024) Measuring the effect of the anti-nerve growth factor antibodies bedinvetmab and frunevetmab on quality of life in dogs and cats with osteoarthritis using a validated health-related quality of life outcome measure: an observational real-world study. Frontiers in Veterinary Science, 11, 1395360. https://doi.org/10.3389/fvets.2024.1395360
Wright, A. et al. (2024) Pet owners’ preferences for quality of life improvements and costs related to innovative therapies in feline pain associated with osteoarthritis – A quantitative survey. Animals, 14 (16), 2308. https://doi.org/10.3390/ani14162308

Safety

All veterinary pharmaceutical agents must provide safety and efficacy data as part of the process of achieving their marketing authorisation, and this information will be included in the summary of product characteristics. However, it is also important to monitor and report adverse events, which includes lack of efficacy, once a product is in use. This information may come from published studies and/or post authorisation pharmacovigilance.

When referring to the frequency of adverse events the definitions of frequency may differ from those in common usage

Very common	≥1/10
Common	≥1/100 to <1/10
Uncommon	≥1/1,000 to <1/100
Rare	≥1/10,000 to <1/1,000
Very rare	<1/10,000

Walters, R.R., Boucher, J.F. and De Toni, F. (2021) Pharmacokinetics and immunogenicity of frunevetmab in osteoarthritic cats following intravenous and subcutaneous administration. Frontiers in Veterinary Science, 8, 687448. https://doi.org/10.3389/fvets.2021.687448
Monteiro, B.P. et al. (2025) Global pharmacovigilance reporting of the first monoclonal antibody for canine osteoarthritis: a case study with bedinvetmab (Librela™). Frontiers in Veterinary Science, 12, 1558222. https://doi.org/10.3389/fvets.2025.1558222
Farrell, M. et al. (2025) Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela). Frontiers in Veterinary Science, 12, 1581490. https://doi.org/10.3389/fvets.2025.1581490

Librela

Veterinary Medicines Directorate (2024) Summary of Product Characteristics: Librela 10 mg solution for injection for dogs [DEFRA] [online]. Available from: https://www.vmd.defra.gov.uk/ProductInformationDatabase/files/SPC_Documents/SPC_2310364.PD [Accessed 8 September 2025]
Veterinary Medicines Directorate (2025) Post Authorisation Assessments: Librela 10 mg solution for injection for dogs [DEFRA] [online]. Available from: https://www.vmd.defra.gov.uk/ProductInformationDatabase/files/PAA_Documents/PAA_2214138.PDF [Accessed 8 September 2025]
Veterinary Medicines. Librela 10 mg – Solution for injection [European Medicines Agency] [online]. Available from: https://medicines.health.europa.eu/veterinary/en/600000001761 [Accessed 8 September 2025]
Librela: EPAR – Medicine overview [European Medicines Agency] [online]. Available from: https://medicineshttps://www.ema.europa.eu/en/medicines/veterinary/EPAR/librela [Accessed 8 September 2025]
Veterinary Medicines Directorate (2025) VMD response to concerns raised following media reports of serious adverse events in dogs administered Librela [DEFRA] [online]. https://www.gov.uk/government/news/librela-solution-for-injection-in-dogs [Accessed 8 September 2025]
U.S. Food & Drug Administration (2024) FDA Standard adverse event review: Librela [FDA] [online] Available: https://www.fda.gov/media/184483/ [Accessed 8 September 2025]

Solensia

Veterinary Medicines Directorate (2024) Summary of Product Characteristics: Solensia 7 mg/ml solution for injection for cats [DEFRA] [online]. Available from: https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_2034950.PDF [Accessed 8 September 2025]
Veterinary Medicines Directorate (2025) Post Authorisation Assessments: Solensia 7 mg/ml solution for injection for cats [DEFRA] [online]. Available from: https://www.vmd.defra.gov.uk/productinformationdatabase/files/PAA_Documents/PAA_2239476.PDF [Accessed 8 September 2025]
Veterinary Medicines Directorate (2025) VMD response to concerns raised following media reports of serious adverse events in cats administered Solensia [DEFRA] [online]. https://www.gov.uk/government/news/solensia-7-mgml-solution-for-injection-for-cats [Accessed 8 September 2025]
Veterinary Medicines. Solensia 7 mg/ml solution for injection [European Medicines Agency] [online]. Available from: https://medicines.health.europa.eu/veterinary/en/600000001761 [Accessed 8 September 2025]

Adverse drug reaction reporting

For those who are interested in reading more about the veterinary pharmacovigilance and adverse drug reaction reporting

De Briyne, N. et al. (2017) Veterinary pharmacovigilance in Europe: a survey of veterinary practitioners. Veterinary Record Open, 4 (1), p. e000224. https://doi.org/10.1136/vetreco-2017-000224
Davies, H. et al. (2022) UK veterinary professionals’ perceptions and experiences of adverse drug reaction reporting. Veterinary Record, 191 (6), p. e1796 https://doi.org/10.1002/vetr.1796
Davies, H. et al. (2024) Recording of suspected adverse drug reaction reporting in veterinary free‐text clinical narratives. Journal of Small Animal Practice, 65 (6), pp. 361-367. https://doi.org/10.1111/jsap.13721

For those with access to Veterinary Prescriber they have a CPD module on Librela which goes through the assessment of benefits and risks in more detail.

About evidence collections

Evidence collections bring together collections of published papers on topics of interest and importance to the veterinary professions. Papers are chosen for relevance and accessibility, with the full text of articles either being available through the RCVS Knowledge library, on open access or from other publications to which a significant number of veterinary professionals are likely to have access. This means that there may be relevant evidence that is not included.

If you would like assistance in searching for further evidence on this topic you may find the following helpful EBVM Toolkit 2: Finding the best available evidence.

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