For many years, canine arthritis has lacked major breakthroughs, despite the tremendous need for better therapies. Now, in 2023 we are witnessing the appearance of a whole new class of treatment.
These are exciting times, but we also need to be cautious. No treatment will work on every dog, and after initial overexcitement, some new products end up being major disappointments. However, with Beransa there is real hope for dogs that we have a new and effective tool to improve their quality of life.
What is Beransa?
Beransa is a trade name for bedinvetmab, also called Librela outside of Australia. It neutralises nerve growth factor (NGF), which has been shown to be involved in the perception of pain. As a monoclonal antibody, it has the potential to be highly specific to its target, and block it almost completely.
In Australia, Beransa has been registered for the alleviation of pain associated with osteoarthritis in dogs.
How Well Does It Work & How Quickly?
In our clinic, we have seen some dogs benefit greatly after starting Beransa, but what does the evidence say? The results of a single placebo-controlled study conducted by the parent company are shown here and referenced below.
They show that after one week, around one in six dogs are showing benefit, which increases to one in two after a month. There are two important things to note here:
- Like with all arthritis treatments, there is a large caregiver placebo effect, so it is important to stay as realistic as possible about its efficacy in each patient
- Many dogs will receive insufficient benefit and need other arthritis remedies either together with or instead of Beransa
Personally, I believe this study and our own experience together are enough to recommend trying Beransa in the right dog.
Beransa Dosage & Frequency
Beransa is given at a dose of 0.5 – 1 mg/kg by subcutaneous injection. It comes in a variety of vial sizes to cater for dogs of different weights. If desired, the dose is repeated every month. It is generally recommended to try at least two doses before deciding whether it is effective enough.
NGF is important for foetal and juvenile development. Therefore, Beransa must not be used in breeding, pregnant or lactating dogs, or those less than 12 months of age.
Human Health Risks
Similarly, pregnant women, women trying to conceive, and breastfeeding women should take extreme care to avoid accidental self injection or needle stick injuries. To be safe, it is best that they take no part in giving the injection or even holding their pet.
Just to be clear, a treated dog poses no risk to humans.
Beransa Side Effects
Reactions such as swelling and heat may occur at the site of injection, but these seem rare. Hypersensitivity reactions are also possible but appear more common in the cat form of this drug, Solensia.
Our experience with monoclonal antibodies like Cytopoint shows us that they are much safer than traditional drugs like anti-inflammatories. This is because as naturally occurring proteins, they require minimal metabolism or detoxification by the liver or kidneys. However, until there are studies of their use with liver or kidney disease, caution is still advisable in these dogs.
Beransa appears safe when used in combination with other drugs, and at the time of vaccination. The only concern with using multiple treatments could be that if an adverse effect occurs, you may not be able to identify the cause.
How Much Does Beransa Cost?
The cost in 2023 for a single injection of Beransa is between $100 and $130 depending on the size required. This is in the same region as the higher price anti-inflammatory drugs.
Beransa or Librela may not be a silver bullet, but just having another option is a great blessing. Our experience so far is that for some dogs, it maintains their quality of life when other choices fail. It can also be used when other treatments aren’t safe enough to use.
Anyone who has an arthritic dog knows that we still aren’t doing enough for them. The development of monoclonal antibodies brings us just one step closer, and just might give us more time to enjoy our lovely old dogs.
Therefore, talk to your vet about whether it might be good for your dog.
References
Corral, M. J., Moyaert, H., Fernandes, T., Escalada, M., Tena, J. K. S., Walters, R. R., & Stegemann, M. R. (2021). A prospective, randomized, blinded, placebo-controlled multisite clinical study of bedinvetmab, a canine monoclonal antibody targeting nerve growth factor, in dogs with osteoarthritis. Veterinary anaesthesia and analgesia, 48(6), 943-955 Full Text
Kronenberger, K. (2023). In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia?. Veterinary Evidence, 8(1) Full Text
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By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.
