Librela is relatively new medication in veterinary medicine for the treatment of Osteoarthritis. Chronically inflamed joints release a protein known as Nerve Growth Factor (NGF).
The NGF will affects the dorsal spinal nerve, the sensory nerve related to that joint, causing the pain signal that then travels to the brain to be exaggerated. Essentially, it turns up the volume on the perception of pain. Librela is an anti-NGF monoclonal antibody that prevents the NGF from influencing the sensory nerve.
Some randomized double blinded controlled clinical trials in humans have found the effects of this drug (the human form) to be positive while other studies have shown them to be equivocal. The most prominent negative finding, in the human studies, is what has been called RPOA (Rapidly Progressive OsteoArthritis) in approximately 29% of the people. The RPOA is thought to be decreasing the discomfort thereby allowing the patient to do activity that is too rigorous for the arthritic joint; leading to a progression of the OA at a much faster rate than anticipated.
Personally, I am a fan of this drug. It is a great tool to add to our toolbox for the management of OA. It can mitigate the pain of OA, allowing the patient to embark on a proper OA management regime. This proper management of the OA should allow the pet to live an active life and be drug free for the most part.
My opinion is to avoid using Librela in the early stage OA patients, the younger patients; or at least to not use it repeatedly in these patients; this way we can mitigate the potential for RPOA to develop.
