From the Department of Neurology, CHV Frégis, Arcueil, France (L.G., L.C.); and Department of Internal Medicine, DFCvet, Rennes, France (M.G.).
J Am Anim Hosp Assoc. 2021 Jan 1;57(1):1-7. doi: 10.5326/JAAHA-MS-7019.
Treatment with high corticosteroid dosages for steroid-responsive meningitis-arteritis (SRMA) is correlated with severe adverse effects and worse quality of life. In order to improve immunosuppression and decrease dosage and duration of glucocorticoid treatment, a second immunosuppressive drug is commonly used in most of the immune-mediated diseases. The objective of this retrospective study was to evaluate the efficacy, tolerability, and occurrence of relapse for the combination of prednisolone and azathioprine. All dogs received azathioprine 2 mg/kg q 24 hr for 1 mo and then 2 mg/kg every other day for 2 mo; prednisolone was started at an immunosuppressive dosage and tapered off gradually during a mean of 3 mo. Twenty-six dogs met inclusion criteria. Twenty-one dogs (81%) were in clinical remission with no relapse observed within the 2 yr follow-up period. Treatment was well tolerated in all dogs and side effects were most of the time mild and self-limiting. The relapse rate (19%) was lower than most published rates. A prednisolone and azathioprine combination appeared to be effective for primary treatment of dogs with SRMA and allows a quicker tapering in prednisolone dosage, a decrease in long-term side effects of steroids, a shorter duration of treatment, and a low relapse rate.
治疗对皮质类固醇剂量敏感的脑膜炎-动脉炎（SRMA）与严重不良反应和生活质量下降相关。为了改善免疫抑制作用并减少糖皮质激素治疗的剂量和持续时间，通常在大多数免疫介导的疾病中使用第二种免疫抑制剂。本回顾性研究的目的是评估泼尼松龙和硫唑嘌呤联合治疗的疗效、耐受性和复发情况。所有犬均接受硫唑嘌呤 2mg/kg q24hr 治疗 1 个月，然后每 2 天治疗 2 个月；泼尼松龙以免疫抑制剂量开始，并在平均 3 个月内逐渐减少剂量。26 只狗符合纳入标准。21 只狗（81%）临床缓解，2 年随访期内无复发。所有狗均耐受良好，副作用大多为轻度和自限性。复发率（19%）低于大多数已发表的比率。泼尼松龙和硫唑嘌呤联合治疗似乎对原发性 SRMA 犬有效，可更快地减少泼尼松龙剂量，减少类固醇的长期副作用，缩短治疗时间，降低复发率。
