Bedinvetmab (Librela/Beransa) in dogs raises safety concerns, including rapidly progressive osteoarthritis, and warrants vigilant adverse event reporting.

Bedinvetmab's NGF blockade may accelerate joint destruction despite pain relief; enhanced surveillance recommended.

Bedinvetmab (Librela/Beransa), a canine anti-nerve growth factor monoclonal antibody approved for osteoarthritis pain management, raises significant safety concerns. While NGF inhibition effectively reduces pain through nociceptive signaling blockade, NGF plays critical roles in bone remodeling and cartilage repair via osteoblast, osteoclast, and chondrocyte modulation. Rapidly progressive osteoarthritis, characterized by accelerated joint destruction and collapse, has been documented in humans, rodents, and rabbits receiving NGF inhibitors, preventing human regulatory approval. Emerging clinical signals suggest bedinvetmab may similarly mask structural deterioration, potentially accelerating osteolysis and chondrolysis in both treated and untreated joints. These adverse events, though reportedly rare, are irreversible and often catastrophic, causing rapid degeneration, osseous collapse, and fractures within months. The authors advocate for comprehensive postmarketing surveillance including baseline and follow-up examinations, standardized imaging protocols, diligent adverse event reporting, and histopathological assessment. Transparent risk communication and informed consent are essential for evidence-based clinical decision-making.

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