Frunevetmab (Solensia; Zoetis) is the only anti-nerve growth factor monoclonal antibody approved for feline osteoarthritis (OA) pain in the USA and is recommended as a first-tier medication for this indication. It is administered at a nominal dose of 1.0 mg/kg SC monthly (effective dose range 1.0–2.8 mg/kg SC), with injections given on days 0, 28, and 56 in the pivotal trial.Journal of Vete…+1

Efficacy is meaningful but moderate in magnitude. In the pivotal controlled trial, frunevetmab produced significant improvement over placebo on owner-assessed client specific outcome measures at days 28 and 56, with a number needed to treat of 9 and a standardized effect size of 0.3 at day 56.Journal of Vete… Veterinarian-assessed joint pain scores improved significantly at days 56 and 84, with an effect size of 0.18 at day 56.Journal of Vete… A single monthly SC injection provides pain relief for at least 1 month in cats with OA.WSAVA Global Gu… The effect size in the pivotal trial was smaller than the 0.74 seen in the earlier pilot proof-of-concept study, which the authors attribute in part to a larger caregiver placebo effect in the later, larger trial.Journal of Vete…

The caregiver placebo effect is a critical factor when counseling clients. The placebo response in feline chronic pain trials is substantially higher than in canine trials, and the gap between placebo and treatment on owner-assessed measures was narrower in the pivotal trial than in earlier work.Journal of Vete… This means that some owners will report improvement regardless of treatment — frame this honestly: objective veterinarian-assessed joint pain scores confirmed a real drug effect, but owner perception alone is not a reliable sole endpoint.Journal of Vete…

Frunevetmab is particularly relevant for cats with concurrent chronic kidney disease (CKD). OA and CKD co-occur in up to 70% of feline cases, and concern about renal toxicity drives reluctance to prescribe long-term non-steroidal anti-inflammatory drugs (NSAIDs) in older cats.Journal of Feli… Frunevetmab does not carry the renal safety concerns associated with NSAIDs and is not associated with organ-level adverse effects.WSAVA Global Gu… This makes it a practical first-line choice in the population most commonly affected by OA.

The primary adverse effect to discuss with clients is skin reactions. In the pivotal trial, skin disorders occurred significantly more frequently in frunevetmab-treated cats (32 of 182 cats) compared to placebo (8 of 93 cats).Journal of Vete… Mild cutaneous reactions such as alopecia have been reported.WSAVA Global Gu… Case reports of more notable cutaneous lesions following frunevetmab injections exist in the literature, so clients should be instructed to monitor injection sites and the coat and report any skin changes promptly.Journal of Feli…

For the client conversation, three points anchor the discussion: monthly SC injection eliminates the daily oral dosing challenge that complicates feline pain managementJournal of Feli…; the drug is approved and first-tier for this indicationJournal of Feli…+1; and while most cats show measurable improvement, the effect is moderate — set expectations around improved mobility and comfort rather than complete resolution, and plan reassessment at 28 and 56 days using consistent owner-reported and veterinarian-assessed outcome measures.Journal of Vete…+1

Would you like guidance on how to monitor treatment response and decide whether to continue, adjust, or combine frunevetmab with other analgesics after the initial 56-day course?