Updated: May 17
Solensia (frunevetmab) is here! Solensia is a monoclonal antibody which targets nerve growth factor, a key mediator in the pain of osteoarthritis.
Why do we think Solensia is such a great option for cats? Firstly, it’s a monthly subcutaneous injection. Secondly, it has a great adverse effect profile with no impact on the liver or kidneys.
Our pain update will give you an introduction to this novel analgesic option for cats. For full details please watch our next webinar here.
Several years back I was asked what the real gaps in the pain management market were for cats – and of course I said I wanted an effective long lasting option for cats. And Solensia offers exactly that.
At Zero Pain Philosophy we don’t receive any financial gain for any pain management products and this pain update is based on our clinical experience and the science behind the product.
Let’s talk about efficacy. Frunevetmab (Solensia) was tested in client-owned cats versus placebo with 181 cats in the frunevetmab group and 93 in the placebo group. The 2:1 allocation to test:placebo is a common model in such studies and widely accepted to conform to the 3Rs principle of refine, reduce & replace. The licensed dose was tested which is 1.0-2.8 mg/kg. The primary endpoint was an owner based assessment – also known as CSOM – client specific outcome measure. This is a very relevant endpoint whereby the client selects behaviours associated with pain in their pet and is asked to score these at each evaluation point. It’s something we can incorporate into our clinical work and I do this with every pain consultation. Of course we know examining cats may not yield the information we need – that something that is widely reported and we will cover in the webinar. Secondary endpoints included a global owner assessment and vet examination. To be included cats needed to be in pain and have radiographic evidence of osteoarthritis in at least two joints.
The first efficacy evaluation was at 28 days at which point 67% of cats in the frunevetmab group had reached treatment success. These numbers increased to 76% at day 56 and 77% at day 84, which was significantly greater than placebo. What is interesting in cats in particular, is that the placebo effect is very evident – something reported previously but not fully understood (Gruen at al 2017). If these numbers are compared to studies using meloxicam in OA, the success rates are higher with Solensia.
The adverse effect profile is favourable for Solensia with reports of dermatitis and focal skin allergy in low numbers of cats in the trial – something we would always mention to the cat owner.
Of course what we would really like is a trial comparing Solensia to an NSAID. Does one offer superior analgesia with a lower incidence of adverse effects?
For some amazing group of resources, head to The New Science of Feline OA Pain. These tools will make your consultations easier and help detect those cats which are hiding their OA.
Watch this space for our review of long term NSAIDs in cats – it’s a common topic. Let’s just say the data is maybe not as clear cut as you may have thought due to the retrospective nature of those studies.
For a full review on NGF, we will be recording a webinar shortly on this topic. If you purchased the cat pain course previously then this webinar will be the perfect addition to complete the chronic pain picture in cats.
This post was written by Matt Gurney.
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.
The intended audience for this pain update is veterinary professionals. This pain update is based on clinical experience and independent opinion.