Sartor Laura Lee, Trepanier Lauren A, Kroll Mandy M, Rodan Ilona, Challoner Laura
University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI 53706-1102, USA.
J Vet Intern Med. 2004 Sep-Oct;18(5):651-5. doi: 10.1892/0891-6640(2004)18<651:easotm>2.0.co;2.
The objective of this study was to determine whether transdermal methimazole was as safe and effective as oral methimazole for the control of hyperthyroidism in cats. Forty-seven cats with newly diagnosed hyperthyroidism were randomized to receive either transdermal methimazole in pluronic lecithin organogel (PLO; applied to the inner pinna), or oral methimazole (2.5 mg q12h for either route). Cats were evaluated at weeks 0, 2, and 4 with a physical exam, body weight determination, CBC, biochemical panel, urinalysis, measurement of total levothyroxine (T4) concentration, indirect Doppler blood pressure determinaiton, and completion of an owner questionnaire. Data between the 2 groups and over time were compared by nonparametric methods. Forty-four cats followed the protocol (17 oral and 27 transdermal). Significantly more cats treated with oral methimazole had serum T4 concentrations within the reference range after 2 weeks (14 of 16 cats) compared to those treated by the transdermal route (14 of 25; P = .027). This difference was no longer significant by 4 weeks of treatment (9 of 11 for oral versus 14 of 21 for transdermal), possibly because of inadequate numbers evaluated by 4 weeks. Cats treated with oral methimazole had a higher incidence of gastrointestinal (GI) adverse effects (4 of 17 cats) compared to the cats treated with transdermal methimazole (1 of 27; P = .04), but no differences were found between groups in the incidence of neutropenia, hepatotoxicity, or facial excoriations. Although the overall efficacy of transdermal methimazole is not as high as that of oral methimazole at 2 weeks of treatment, it is associated with fewer GI adverse effects compared to the oral route.
本研究的目的是确定透皮甲巯咪唑在控制猫甲状腺功能亢进方面是否与口服甲巯咪唑一样安全有效。47只新诊断为甲状腺功能亢进的猫被随机分为两组，分别接受聚醚砜卵磷脂有机凝胶（PLO）中的透皮甲巯咪唑（涂抹于耳内）或口服甲巯咪唑（两种途径均为2.5mg，每12小时一次）。在第0、2和4周对猫进行评估，包括体格检查、体重测定、血常规、生化指标、尿液分析、总甲状腺素（T4）浓度测量、间接多普勒血压测定以及完成主人问卷。采用非参数方法比较两组之间以及不同时间的数据。44只猫遵循了方案（17只口服，27只透皮）。与透皮途径治疗的猫（25只中的14只）相比，口服甲巯咪唑治疗的猫在2周后血清T4浓度在参考范围内的数量显著更多（16只中的14只；P = 0.027）。到治疗4周时，这种差异不再显著（口服组11只中的9只，透皮组21只中的14只），可能是因为4周时评估的数量不足。与透皮甲巯咪唑治疗的猫（27只中的1只；P = 0.04）相比，口服甲巯咪唑治疗的猫胃肠道（GI）不良反应发生率更高（17只中的4只），但两组在中性粒细胞减少、肝毒性或面部擦伤的发生率方面没有差异。虽然在治疗2周时透皮甲巯咪唑的总体疗效不如口服甲巯咪唑，但与口服途径相比，其胃肠道不良反应较少。
