Smith P M, Stalin C E, Shaw D, Granger N, Jeffery N D
Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
J Vet Intern Med. 2009 May-Jun;23(3):520-6. doi: 10.1111/j.1939-1676.2009.0299.x.
The optimal treatment for meningoencephalomyelitis of unknown etiology (MUE) remains unknown, despite the widespread use of a variety of immunosuppressive drugs.
OBJECTIVE/HYPOTHESIS: To compare the efficacy of prednisolone combined with either vincristine and cyclophosphamide (COP group; n= 10) or with cytosine arabinoside (AraC group; n= 9).
Nineteen dogs with neurological deficits, neuroimaging, and cerebrospinal fluid abnormalities consistent with a diagnosis of MUE.
Prospective, blinded, and randomized clinical trial. Dogs fulfilling the inclusion criteria were randomly allocated to receive 1 drug regimen.
Four of 10 dogs in the COP group and 5/9 in the AraC group survived > 12 months but neither the survival time nor the time-to-treatment failure differed between the 2 groups. Treatment with COP resulted in an unacceptable incidence of adverse effects.
The adverse effects of COP make it an unsuitable treatment for MUE. Although survival of animals treated with AraC was broadly similar to that reported in recently published studies describing this treatment, it remains unclear whether it confers any benefit over using prednisolone alone.
尽管广泛使用了多种免疫抑制药物，但病因不明的脑膜脑脊髓炎（MUE）的最佳治疗方法仍不明确。
目的/假设：比较泼尼松龙联合长春新碱和环磷酰胺（COP组；n = 10）或联合阿糖胞苷（AraC组；n = 9）的疗效。
19只患有神经功能缺损、神经影像学和脑脊液异常且符合MUE诊断的犬。
前瞻性、盲法和随机临床试验。符合纳入标准的犬被随机分配接受1种药物治疗方案。
COP组10只犬中有4只、AraC组9只中有5只存活超过12个月，但两组之间的生存时间和治疗失败时间均无差异。COP治疗导致不良事件发生率不可接受。
COP的不良反应使其不适用于MUE的治疗。尽管接受AraC治疗的动物存活率与最近发表的描述该治疗方法的研究报告大致相似，但尚不清楚它是否比单独使用泼尼松龙有任何益处。
