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. 2021 Nov;35(6):2752-2762.
doi: 10.1111/jvim.16291. Epub 2021 Nov 1.

Frunevetmab, a felinized anti-nerve growth factor monoclonal antibody, for the treatment of pain from osteoarthritis in cats

Margaret E Gruen  1   2   3 , Jamie A E Myers  4 , Jezaniah-Kira S Tena  4 , Csilla Becskei  5 , Dawn M Cleaver  4 , B Duncan X Lascelles  1   3   6   7
Affiliations

Frunevetmab, a felinized anti-nerve growth factor monoclonal antibody, for the treatment of pain from osteoarthritis in cats

Margaret E Gruen et al. J Vet Intern Med. 2021 Nov.

Abstract

Background: Frunevetmab, a felinized antinerve growth factor monoclonal antibody, effectively decreases osteoarthritis (OA) pain in cats.

Objective: To evaluate the efficacy of frunevetmab given at monthly intervals in a randomized, placebo-controlled, parallel-group, double-blind superiority study.

Animals: Two hundred seventy-five client-owned cats with naturally-occurring OA pain and associated mobility impairment and disability.

Methods: Randomized, placebo-controlled, parallel-group, double-blind, superiority study. Following screening, cats received frunevetmab (nominal dose of 1.0 mg/kg, SC [effective dose range of 1.0-2.8 mg/kg]) or placebo on days 0, 28, and 56. Outcome measures were owner questionnaires and veterinary physical and orthopedic evaluations at days 28, 56, and 84. Success/failure rates (and numbers needed treat, NNT) and change in scores (and standardized effect size, ES) were analyzed.

Results: Frunevetmab (182) and placebo (93) treated cats were enrolled and received at least 1 treatment. Significant improvement with frunevetmab over placebo occurred at days 28 and 56 for the client specific outcome measures (CSOM) questionnaire (success rates and total scores [NNT of 9 and ES of 0.3 at day 56]); at days 28 and 56 for owner-assessed global treatment response; and at days 56 and 84 for veterinarian-assessed joint pain (ES of 0.18 at day 56). Adverse events did not differ between groups, except skin disorders which collectively occurred significantly more frequently in frunevetmab treated (32/182 cats) vs placebo (8/93 cats).

Conclusions and clinical importance: Frunevetmab has the potential to address a critical gap in the treatment of pain because of osteoarthritis in cats.

Keywords: CSOM; FMPI; arthritis; client specific outcome measures; degenerative joint disease; feline; feline musculoskeletal pain index.

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Conflict of interest statement

Jamie A. E. Myers, Jezaniah‐Kira S. Tena, Csilla Becskei, and Dawn M. Cleaver are employed by Zoetis; Margaret E. Gruen and B. Duncan X. Lascelles have received honoraria for continuing education lectures sponsored by Zoetis; Margaret E. Gruen and B. Duncan X. Lascelles are paid consultants for Zoetis.

Figures

FIGURE 1
FIGURE 1
Schematic of study timeline
FIGURE 2
FIGURE 2
CONSORT flow diagram describing all the cases recruited to the study. †Specifically for a priori CSOM day 56 analysis. *Cats withdrawn for owner perceived lack of effect were included in efficacy analysis as treatment failures. 1One cat removed day 12 for unrelated chronic cardiomyopathy, CKD, and chronic gastroenteritis; 1 cat removed day 22 for myocardial fibrosis and renal disease; 1 cat removed day 28 at owner's election because of worsening of intermittent vomiting. 2One cat removed day 13 for use of a prohibited medication, 1 cat removed day 25 because of owner's inability to complete assessments. 3One cat removed day 0 for receiving incorrect treatment. 4One cat had day 56 visit out of window, 1 cat was removed because of use of prohibited
FIGURE 3
FIGURE 3
Percentage of cats with treatment success, where success is defined as a reduction in the client specific outcome measure (CSOM) score of ≥2 for any individual cat. The number of successes in each group were compared using appropriate methods for binary outcomes (GLIMMIX procedure in SAS) at study days 28, 56, and 84. *P < .05 indicating a significantly greater percentage of cats in the frunevetmab group were designated successes
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