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question everything

(49,107 posts)
Wed Dec 18, 2024, 06:05 PM Dec 18

FDA Warns About Dangers of Dog Pain Drug

The Food and Drug Administration is warning veterinarians about deaths, debilitating neurological issues and other side effects that followed use of a popular arthritis drug for dogs.

The agency said, in a letter to veterinarians posted on its website, that side effects reported for Zoetis’s drug Librela included seizures, lameness and loss of muscle control. The agency said some dogs were euthanized and others died as a result of the side effects.

The agency issued the warning on Monday following a review of more than 3,600 cases of side effects that were reported to the FDA between last year and March 2024.

https://www.wsj.com/health/pharma/fda-warns-about-dangers-of-dog-pain-drug-61b1dd63?st=XrTtGT&reflink=desktopwebshare_permalink

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Mike 03

(17,385 posts)
1. Wow. Not good
Wed Dec 18, 2024, 06:17 PM
Dec 18

Never heard of this drug. My dogs have all been on either Galliprant or Rimadyl. It looks like this drug was approved relatively recently.

Hope none of our beloved DU dogs have been affected.

Thanks for bringing this to everyone's attention. Could be of concern to many dog owners.

Mike 03

(17,385 posts)
3. This drug is also known as Bedinvetmab. Some pre-warning info from Wikipedia:
Wed Dec 18, 2024, 06:21 PM
Dec 18
https://en.wikipedia.org/wiki/Bedinvetmab

Bedinvetmab, sold under the brand name Librela is a canine monoclonal antibody used for the control of pain associated with osteoarthritis in dogs.[3][4][5] Librela is sponsored by Zoetis.[5][6]

The most common side effects include increased blood urea nitrogen (an indicator of kidney function), urinary tract infection, bacterial skin infection, skin irritation (dermatitis), rash (erythema) or pain at injection site, vomiting (emesis), and weight loss (anorexia).[5]

Bedinvetmab was approved for medical use in the European Union in November 2020,[4] and in the United States in May 2023.[5][6] Bedinvetmab is the first monoclonal antibody approved in the United States for controlling osteoarthritis pain in dogs.[5]

hlthe2b

(106,827 posts)
4. It is a injectable monoclonal antibody that is directed at the inflammatory release from Nerve Growth Factor
Wed Dec 18, 2024, 06:29 PM
Dec 18

While this bears watching, it is important to know it has been used in Europe for more than three years with few issues. Granted rare side effects may not show up until hundreds of thousands (or more) dogs have been treated, but the data from Zoetis did not alarm FDA during the initial approvals. And veterinarians are reporting very good results when used as intended for severe osteoarthritis.

FDA is not recalling the product so that means it bears watching but there is not clear data supporting doing so (meaning there may be other causes for the seizures--especially since the oldest dogs tend to be the ones with the most severe intractable osteoarthritis and the older the dog, the more likely they may have other issues going on as well)

hlthe2b

(106,827 posts)
5. Zoetis response:
Wed Dec 18, 2024, 06:34 PM
Dec 18
https://www.wsj.com/health/pharma/fda-warns-about-dangers-of-dog-pain-drug-61b1dd63?st=XrTtGT&reflink=desktopwebshare_permalink



Today’s Veterinary Business Staff

Today’s Veterinary Business Staff - Featured Image

The U.S. Food and Drug Administration has issued a “Dear Veterinarian” letter notifying practitioners about adverse events reported in dogs treated with Librela (bedinvetmab injection). The monoclonal antibody drug is indicated for the control of pain associated with osteoarthritis in dogs.

The FDA’s Center for Veterinary Medicine is recommending that the current label get a “Post Approval Experience” section and that “owners be advised of the adverse reactions that may occur following administration of Librela.”

According to the FDA, the most commonly noted adverse events involved ataxia, anorexia, lethargy and polydipsia. Deaths were also reported.

Librela’s manufacturer, Zoetis, released the following statement:

“Today, the FDA issued an update on Librela, which includes a summary and standard agency review of the adverse events that have been reported since launch in the U.S.

“Safety updates, issued in the years following a product launch, serve to educate the vet and pet owners and facilitate a discussion between the two.

“The information shared by the FDA today is consistent with what we’ve seen in our pharmacovigilance data. We maintain regular communication with the FDA to ensure the ongoing safety and efficacy of our products. We have been collaborating with the FDA to help contextualize the data. Zoetis is in discussions with the FDA on label updates and expects it will reflect post approval adverse event reporting and be more similar to labels in other markets.

“We continue to have the utmost confidence in the safety and efficacy of Librela. Since launching in Europe over three years ago, Librela has been used effectively with millions of dogs suffering from osteoarthritis pain. With more than 21 million doses distributed globally, no individual adverse event sign is reported at a rate higher than rare, as defined by the European Medicines Agency (EMA) as

hlthe2b

(106,827 posts)
6. Here is the original letter sent by FDA to veterinarians:
Wed Dec 18, 2024, 06:40 PM
Dec 18
https://www.fda.gov/animal-veterinary/product-safety-information/dear-veterinarian-letter-notifying-veterinarians-about-adverse-events-reported-dogs-treated-librela

FDA notifies veterinarians about adverse events reported for Librela

Dear Veterinarian,

The U.S. Food and Drug Administration’s Center for Veterinary Medicine has completed an evaluation of adverse events reported in dogs of various ages treated with Librela (bedinvetmab injection). The adverse events identified and analyzed include: ataxia, seizures, other neurologic signs, including but not limited to, paresis, recumbency, urinary incontinence; polyuria, and polydipsia. In some cases, death (including euthanasia) was reported as an outcome of these adverse events. The FDA is making available reports containing summaries of clinical signs reported for Librela in the CVM FOIA Electronic Reading Room.
Drug Information

The FDA approved Librela, a monoclonal antibody drug used for the control of pain associated with osteoarthritis in dogs, on May 5, 2023, and it was introduced to the marketplace later that year. Prior to approval, the FDA reviewed available studies and other data on Librela and determined Librela to be safe and effective for its intended use for control of pain associated with osteoarthritis in dogs. Librela is dosed by weight and labeled for subcutaneous injection once a month.
What should a veterinarian do if a patient treated with Librela has an adverse event?

If a dog under your care experiences an adverse event while receiving Librela, the FDA encourages you to report it to Zoetis, the drug sponsor, at 1-888‑963-8471. Drug sponsors are required to submit reports of adverse drug events to FDA. If you prefer to report directly to FDA, please see www.fda.gov/reportanimalae.

When reporting adverse events to the FDA and/or Zoetis, please include, if available, a full medical history, how many times the dog has received Librela, and the lot number on the vial used.
Where can veterinarians get more information about the adverse events that have been reported to the FDA?

The FDA is posting reports containing adverse drug event information for Librela on a rolling basis in the CVM FOIA Electronic Reading Room. If the agency has additional information to share, it will be made available.
Additional Information

The FDA monitors the safety profile of all animal drugs after they reach the market, as widespread use of a drug in a large number of patients may uncover adverse events not observed prior to approval. Pharmaceutical companies (drug sponsors) are required to report all cases of adverse events they receive from the public, including pet owners and veterinarians, to the FDA. The agency evaluates adverse events and other safety information when it becomes available. When appropriate, FDA works with the drug sponsor to address any concerns. FDA may request updates to drug labeling, post-approval studies, or require additional or more frequent reporting. The FDA Center for Veterinary Medicine does not currently have the authority to mandate safety-related labeling changes.

For more information on drug sponsor’s responsibilities to report adverse events, see Post-approval Animal Drug Reporting Requirements.

The FDA also makes available Animal Drug Safety-Related Labeling Changes on a regular basis. Please see the button on the page to subscribe to email updates.

The FDA’s Center for Veterinary Medicine (CVM) is committed to promoting and protecting animal health by ensuring marketed animal drugs are safe and effective. For more information, please contact AskCVM@fda.hhs.gov.

Sincerely,

FDA’s Center for Veterinary Medicine

hlthe2b

(106,827 posts)
8. THis treatment is more often given to the oldest, most severely afflicted arthritic dogs and the description
Wed Dec 18, 2024, 06:46 PM
Dec 18

of the side effects in this limited number of dogs do NOT rule out that the arthritis was already so advanced as to cause rear limb paresis (loss of muscle tissue occurs in end-stage causing these afflicted old dogs to not be able to get up) and the lateral recumbency, loss of urinary control is pretty common for these end-stage dogs and is typically why they are brought in to be euthanized. It is not at all clear there was any attempt to differentiate this or another ongoing severe disease issue.

The above is important to realize when interpreting this report. I'm glad that FDA is alerting veterinarians to be alert and to submit "detailed" reports of complications, but as with vaccines and autism in humans, it is quite easy to misinterpret what is causal and not.

liberalmediaaddict

(952 posts)
7. My dog has been on Librela for 6 months
Wed Dec 18, 2024, 06:45 PM
Dec 18

It's really helped with her osteoarthritis.
Haven't noticed any side effects.

The WSJ, Newsweek, Daily Mail and New York Post are really exaggerating what the FDA actually said.

It's like the warning labels on antidepressants. They have to list all possible side effects just in case.

There's always risks with any drug. Librela definitely isn't a miracle cure. But it has helped relieve hip and joint pain in a lot of aging dogs.

hlthe2b

(106,827 posts)
9. This is the experience overwhelmingly in dogs treated both in Europe and more recently in the US...
Wed Dec 18, 2024, 06:50 PM
Dec 18

I saw the immediate reactions upstream and that is why I've tried to put this into perspective. I think the reports are largely confounded by the end-stage of dogs treated so late so as to be unaffected by Librela or which had other ongoing disease conditions, whether fully diagnosed or not.

I really hate it now that most media have gotten rid of any well-trained science and medicine reporters/editors. There is far too much sensationalism or misinterpretation now.

liberalmediaaddict

(952 posts)
10. Totally agree
Wed Dec 18, 2024, 07:07 PM
Dec 18

I read the warnings about librela before agreeing to start my elderly dog on the shots. Honestly the drug has helped prolong her life and keep her active. She's able to take long walks and her joints aren't as stiff.

Hopefully the FDA warning doesn't discourage dog owners from trying the drug. When a dog reaches a certain age and can barely move because of arthritis and degenerative joint disease there's usually no options
other than euthanasia. Vets wouldn't recommend Librela unless they were confident it can help. They don't want to get sued.

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