Journal Scan: Cats with chronic DJD pain, rejoice!
Many adult and geriatric cats have evidence and clinical signs of degenerative joint disease (DJD). Unfortunately, long-term pain relief for feline patients has always been problematic as no drugs have been approved for long-term pain control in cats. Long-term use of meloxicam is approved in Europe but is strongly discouraged in the U.S. due to concerns about renal damage.
Neutralizing antibodies against nerve growth factor (NGF) have been proven to provide long-term analgesia in both humans and rodents. A newly developed feline anti-NGF antibody, NV-02, was recently examined to determine its efficacy in treating DJD-associated pain and mobility impairment in felines. The study was also designed to determine how long the analgesia would last.
The authors recruited 36 cats for the study who had owner-reported mobility impairment, pain noted in at least two joints or spinal segments during an orthopedic exam and radiographic evidence of DJD in at least two of those painful joints or spinal segments. A complete blood count (CBC), blood chemistry, T4 test and urinalysis were performed to make sure the participants were otherwise healthy, and clients completed both a feline musculoskeletal pain index (FMPI) and a client-specific outcome measures (CSOM) questionnaire. Each cat was fitted with an accelerometer and was monitored for two weeks to determine baseline activity.
On day 14, FMPI and CSOM questionnaires were again completed before the cats were given an injection of either the placebo or the drug. The feline participants were randomly assigned into three groups of twelve cats according to treatment: placebo, low dosage NV-02 and high dosage NV-02. All involved in the study were blinded as to which treatment each cat received.
The cats were then monitored for nine weeks, and FMPI/CSOM scores were recorded at two intermediate points (days 35 and 56). At the end of the nine weeks, FMPI/CSOM scores were again logged, and a CBC, blood chemistry and urinalysis were repeated.
The results of the study demonstrated a clear positive response to treatment with the novel anti-NGF antibody—an effect that was seen for both objectively measured activity and owner-assessed subjective data (despite the presence of a large caregiver placebo effect).
Although differences in FMPI score results were not as striking between placebo and NV-02 groups, CSOM scores and accelerometer data showed clear differences. The response to treatment lasted approximately six weeks, and increase in activity compared favorably to previous studies done with meloxicam. Researchers also found that the drug was well tolerated and no related adverse events occurred during the study.
Reason to rejoice
The feline anti-NGF antibody NV-02 was demonstrated to provide safe and effective relief from DJD in cats for approximately six weeks with a single injection, bolstering the hope of being able to use NC-02 as an effective long-term drug to treat DJD-associated pain in cats. Since the study, the drug has been named frunevetmab and has been recommended for further investigation of safety and efficacy.
Gruen ME, Thomson AE, Griffith EH, 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;30(4):1138–1148.
Link to full article: http://onlinelibrary.wiley.com/doi/10.1111/jvim.13972/full