Royaux E, Van Ham L, Broeckx B J G, Van Soens I, Gielen I, Deforce D, Bhatti S F M
Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Vet J. 2017 Feb;220:51-54. doi: 10.1016/j.tvjl.2017.01.002. Epub 2017 Jan 4.
Imepitoin has recently been approved in Europe for the management of dogs with idiopathic epilepsy. Currently, there is no evidence-based information available on the efficacy of antiepileptic drugs used as additions to the therapeutic regimen in dogs with idiopathic epilepsy that are not well controlled with imepitoin. The goal of this study was to evaluate the efficacy of phenobarbital or potassium bromide (KBr) as add-on antiepileptic drugs for controlling dogs refractory to a maximum dose of imepitoin (30 mg/kg twice daily). The study was performed as a prospective, randomised, controlled clinical trial. The efficacy of phenobarbital and KBr was evaluated by comparing monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), the presence of cluster seizures during a retrospective 2-month period with a prospective follow-up of 6 months, and the overall responder rate. Twenty-seven dogs were included in the study, 14 dogs in the phenobarbital group and 13 dogs in the KBr group. Both median MSF and MSDF decreased in the phenobarbital group (both P = 0.001) and in the KBr group (P = 0.004 and P = 0.003, respectively). Overall, the number of dogs with cluster seizures decreased (P = 0.0005). The responder rate was 79% vs. 69% in the phenobarbital and KBr groups, respectively. We conclude that phenobarbital or KBr add-on treatment decreases median MSF and MSDF in epileptic dogs refractory to a maximum dose of imepitoin. Combination therapy was generally well tolerated and resulted in an improvement in seizure management in the majority of the dogs.
艾美苯妥英最近在欧洲被批准用于治疗特发性癫痫的犬类。目前，对于在使用艾美苯妥英治疗效果不佳的特发性癫痫犬中，作为治疗方案补充用药的抗癫痫药物的疗效，尚无基于证据的信息。本研究的目的是评估苯巴比妥或溴化钾（KBr）作为添加抗癫痫药物，对最大剂量艾美苯妥英（每日两次，每次30mg/kg）治疗无效的犬的控制效果。该研究作为一项前瞻性、随机、对照临床试验进行。通过比较每月癫痫发作频率（MSF）、每月癫痫发作日频率（MSDF）、回顾性2个月期间及前瞻性6个月随访期间的丛集性癫痫发作情况以及总体缓解率，来评估苯巴比妥和KBr的疗效。27只犬被纳入研究，苯巴比妥组14只犬，KBr组13只犬。苯巴比妥组的MSF和MSDF中位数均下降（P均=0.001），KBr组的MSF和MSDF中位数也下降（分别为P=0.004和P=0.003）。总体而言，丛集性癫痫发作的犬只数量减少（P=0.0005）。苯巴比妥组和KBr组的缓解率分别为79%和69%。我们得出结论，苯巴比妥或KBr添加治疗可降低最大剂量艾美苯妥英治疗无效的癫痫犬的MSF和MSDF中位数。联合治疗通常耐受性良好，且使大多数犬的癫痫管理得到改善。
