Cummings F O, Rizzo S A
Practice Limited to Internal Medicine, Louisville, Kentucky 40223, USA.
J Small Anim Pract. 2017 Feb;58(2):96-102. doi: 10.1111/jsap.12621.
The objective of this study was to compare hospitalisation duration, survival times, adverse events and cost of therapy in dogs with presumptive primary immune-mediated thrombocytopenia undergoing therapy with mycophenolate mofetil and corticosteroids versus cyclosporine and corticosteroids.
A retrospective study of medical case records of dogs with presumed primary immune-mediated thrombocytopenia was conducted. Data collected included signalment, presenting complaints, haematologic and biochemical profiles, vector-borne disease testing, thoracic and abdominal radiographs, abdominal ultrasound, medications administered, duration of hospitalisation, 30- and 60-day survival, adverse events and cost of therapy. Variables were compared between dogs treated solely with mycophenolate mofetil and corticosteroids or cyclosporine and corticosteroids.
A total of 55 dogs with primary immune-mediated thrombocytopenia were identified. Eighteen were excluded because multiple immunosuppressive medications were used during treatment. Hospitalisation times, 30-day survival and 60-day survival times were similar between both groups. Dogs in the mycophenolate mofetil/corticosteroid group experienced fewer adverse events than the cyclosporine/corticosteroid group. Therapy with mycophenolate mofetil was less expensive than that with cyclosporine.
These results suggest that using the combination of mycophenolate mofetil and corticosteroids appears to be as effective as cyclosporine and corticosteroids in the treatment of presumed primary immune-mediated thrombocytopenia in dogs. Adverse events were less common and cost of therapy was lower in the mycophenolate mofetil group. Additional larger prospective, controlled, double-masked, outcome-based, multi-institutional studies are required to substantiate these preliminary findings.
本研究的目的是比较接受霉酚酸酯和皮质类固醇治疗与环孢素和皮质类固醇治疗的疑似原发性免疫性血小板减少症犬的住院时间、生存时间、不良事件和治疗费用。
对疑似原发性免疫性血小板减少症犬的医疗病例记录进行回顾性研究。收集的数据包括特征、就诊主诉、血液学和生化指标、媒介传播疾病检测、胸部和腹部X光片、腹部超声、用药情况、住院时间、30天和60天生存率、不良事件和治疗费用。对仅接受霉酚酸酯和皮质类固醇或环孢素和皮质类固醇治疗的犬之间的变量进行比较。
共确定了55只原发性免疫性血小板减少症犬。18只被排除，因为治疗期间使用了多种免疫抑制药物。两组之间的住院时间、30天生存率和60天生存率相似。霉酚酸酯/皮质类固醇组的犬比环孢素/皮质类固醇组经历的不良事件更少。霉酚酸酯治疗比环孢素治疗成本更低。
这些结果表明，在治疗疑似犬原发性免疫性血小板减少症方面，使用霉酚酸酯和皮质类固醇的联合治疗似乎与环孢素和皮质类固醇一样有效。霉酚酸酯组的不良事件较少见，治疗成本较低。需要更多更大规模的前瞻性、对照、双盲、基于结果的多机构研究来证实这些初步发现。
