Perego Roberta, Spada Eva, Foppa Caterina, Proverbio Daniela
Department of Veterinary Medicine (DIMEVET), University of Milan, Via G. Celoria 10, 20133, Milan, Italy.
BMC Vet Res. 2019 Jan 7;15(1):17. doi: 10.1186/s12917-018-1767-7.
Canine generalised demodicosis is an inflammatory parasitic skin disease caused by an excessive proliferation of Demodex spp. Generalized demodicosis is a severe skin disease, that can be life threatening if not treated properly. Many of the current treatment options are not licensed for the treatment of generalised demodicosis, it have a low safety margin and may be poorly efficacious and time-consuming for the owner; there is a need for a safe, efficacious treatment for canine demodicosis. Our objective was to systematically review the literature to determine the most effective and safe topical or systemic therapy for canine generalised demodicosis. Single case reports and case series with fewer than five patients were not reviewed as they were considered to be poor quality evidence. A detailed literature search identified 21 relevant clinical trials and these were critically assessed.
The analysis of the best available evidence on March 5, 2018, suggests that six are the most effective and safe treatments for generalised canine demodicosis including (in alphabetical order): doramectin (oral or parenteral); fluralaner (oral); imidacloprid/moxidectin (topical); ivermectin (oral, not as first choice treatment); milbemycin oxime (oral); and sarolaner (oral). There was insufficient evidence to allow comment on the appropriateness of other treatment protocols for canine generalised demodicosis in this CAT.
In our critical appraisal of the best scientific literature, there is evidence for recommending the use of 6 therapeutic options against demodectic mange. Further, in vivo, controlled, randomized and blinded clinical trials are required, to evaluate new therapies.
犬全身性蠕形螨病是一种由蠕形螨过度增殖引起的炎症性寄生虫性皮肤病。全身性蠕形螨病是一种严重的皮肤病，若治疗不当可能危及生命。目前的许多治疗方法未获许可用于治疗全身性蠕形螨病，其安全范围窄，对犬主而言可能疗效不佳且耗时；因此需要一种安全有效的犬蠕形螨病治疗方法。我们的目的是系统回顾文献，以确定治疗犬全身性蠕形螨病最有效和安全的局部或全身疗法。单病例报告和患者少于五例的病例系列未纳入综述，因为它们被认为是质量较差的证据。详细的文献检索确定了21项相关临床试验，并对这些试验进行了严格评估。
2018年3月5日对现有最佳证据的分析表明，以下六种是治疗犬全身性蠕形螨病最有效和安全的疗法（按字母顺序排列）：多拉菌素（口服或肠胃外给药）；氟拉尼（口服）；吡虫啉/莫昔克丁（局部用药）；伊维菌素（口服，非首选治疗药物）；米尔贝肟（口服）；以及沙罗拉尼（口服）。本循证医学评价中没有足够证据对犬全身性蠕形螨病的其他治疗方案的适用性发表评论。
在我们对最佳科学文献的批判性评价中，有证据支持推荐使用6种治疗蠕形螨病的疗法。此外，需要进行体内、对照、随机和盲法临床试验，以评估新的疗法。
