Sato M, Veir J K, Legare M, Lappin M R
Department of Clinical Sciences, Colorado State University, Fort Collins, CO.
Department of Environment & Radiological Health Science, Colorado State University, Fort Collins, CO.
J Vet Intern Med. 2017 Sep;31(5):1502-1507. doi: 10.1111/jvim.14810. Epub 2017 Aug 21.
Little clinical information is available concerning the use of leflunomide in dogs with immune-mediated diseases.
To report the safety and efficacy of leflunomide for the treatment of naturally occurring immune-mediated diseases in dogs.
Ninety-two dogs treated with leflunomide for management of suspected immune-mediated diseases.
Retrospective medical record review from Jan 1995 to Dec 2014. Data that were extracted from the medical records included signalment, body weight, underlying indication for leflunomide, dosage of leflunomide, treatment duration, concurrent medications, treatment response, and adverse events.
Adverse events that could be related to leflunomide administration included diarrhea (3 of 92, 3.3%), lethargy (2 of 92, 2.2%), unexplained hemorrhage (3 of 92, 3.3%), thrombocytopenia (2 of 31, 6.5%), and increased liver enzyme activities (1 of 16, 6.3%). Significant dose differences between dogs with adverse events (n = 11; median, 2.9 mg/kg/d; range, 1.8-3.6 mg/kg/d) and dogs without adverse events (n = 81; median, 1.6 mg/kg/d; range, 0.8-4.3 mg/kg/d) were found (P < 0.001). Treatment response could be evaluated in 17 dogs. Of these 17 dogs, 12 dogs (70.5%) had an apparent positive response to the use of leflunomide. There was no significant difference (P = 0.22) in dosages between dogs that responded to leflunomide (n = 12; median, 1.9 mg/kg/d; range, 1.0-3.5 mg/kg/d) and those that did not respond (n = 5; median, 1.7 mg/kg/d; range, 1.0-2.0 mg/kg/d).
Results suggest that the starting dosage of leflunomide should be 2 mg/kg/d rather than the currently suggested dosage of 3-4 mg/kg/d.
关于来氟米特在患有免疫介导性疾病的犬类中的应用，临床信息较少。
报告来氟米特治疗犬类自然发生的免疫介导性疾病的安全性和有效性。
92只接受来氟米特治疗疑似免疫介导性疾病的犬。
回顾性查阅1995年1月至2014年12月的病历。从病历中提取的数据包括特征、体重、来氟米特的潜在适应症、来氟米特剂量、治疗持续时间、同时使用的药物、治疗反应和不良事件。
可能与来氟米特给药相关的不良事件包括腹泻（92只中有3只，3.3%）、嗜睡（92只中有2只，2.2%）、不明原因出血（92只中有3只，3.3%）、血小板减少（31只中有2只，6.5%）和肝酶活性升高（16只中有1只，6.3%）。发现发生不良事件的犬（n = 11；中位数，2.9 mg/kg/d；范围，1.8 - 3.6 mg/kg/d）与未发生不良事件的犬（n = 81；中位数，1.6 mg/kg/d；范围，0.8 - 4.3 mg/kg/d）之间存在显著剂量差异（P < 0.001）。可对17只犬的治疗反应进行评估。在这17只犬中，12只犬（70.5%）对来氟米特的使用有明显阳性反应。对来氟米特有反应的犬（n = 12；中位数，1.9 mg/kg/d；范围，1.0 - 3.5 mg/kg/d）与无反应的犬（n = 5；中位数，1.7 mg/kg/d；范围，1.0 - 2.0 mg/kg/d）之间的剂量无显著差异（P = 0.22）。
结果表明，来氟米特的起始剂量应为2 mg/kg/d，而非目前建议的3 - 4 mg/kg/d。
