REVIEW 2025 – Questions of trust in Librela row

When eminent clinicians clash with each other on the floor of a veterinary congress, it tends to stick in the mind as a rarity, at least in this humble correspondent’s experience.

So when Mike Farrell and John Innes argued about the impact of the canine osteoarthritis drug Librela at the VOACON congress in Loughborough in May, it mattered.

Part of its significance, beyond the unusually heated nature of the exchange which delegates witnessed that day, was in its timing.

Although concerns about the drug and its potential effects had been growing for some time by that stage, the event represented the first major exploration of the competing arguments at a UK veterinary conference.

But it also posed critical questions of confidence, not simply in the process of how medicines are developed but in the clinicians who recommend them to their clients every day.

Petition

Indeed, a petition which had called for a halt to the drug’s sale even prior to the Loughborough exchanges, argued that trust in the profession was at risk of being “undermined” by the issue.

The need for manufacturers to be able to demonstrate the effectiveness of their products has perhaps never been greater, as was acknowledged in a broader context by senior European vets in the spring.

As the year wore on, the Librela argument did not leave the conference hall entirely, but did spread into different arenas, perhaps most notably US courtrooms, as the question of its usage became as much a legal one as a clinical one.

Closer to home, the issue also raised difficult questions for regulators as they admitted failings with a reporting portal which critics believed was preventing issues with Librela from being raised.

Rebuttal

Although the VMD argued other reporting mechanisms remained available, and its new portal is expected to come online early in the new year, the portal problem had itself been raised during the VOACON debate.

Throughout the year, the drug’s manufacturer, Zoetis, repeatedly insisted it remained fully confident in both Librela and its feline equivalent, Solensia, citing both the tens of millions of doses distributed and the rarely reported nature of the impacts observed.

It would later mount a further rebuttal of the conclusions presented at VOACON, amid broader calls for more information about the drug’s effects to help frontline clinicians assess the risks to their own patients.

Yet if that wasn’t enough to show the issue is likely to remain firmly to the fore in 2026, the emergence of a new and longer lasting treatment, Levinia, in the autumn opened up a whole new front in the debate.