评估阿糖胞苷在治疗复发性犬类类固醇反应性脑膜炎-动脉炎中的应用。
Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid-responsive meningitis-arteritis.
机构信息
Clinic of Small Animal Surgery/Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Neurology/Neurosurgery, Southern Counties Veterinary Specialists LLP, Ringwood, Hampshire, UK.
出版信息
Vet Rec. 2020 Jul;187(1):e7. doi: 10.1136/vr.105683.
BACKGROUND
Relapses in steroid-responsive meningitis-arteritis (SRMA) are frequently observed but specific treatment protocols to address this problem are sparsely reported. Standard treatment includes prolonged administration of glucocorticoids as monotherapy or in combination with immunosuppressive drugs. The aim of this study was to assess the safety and efficacy of cytosine arabinoside (CA) in combination with glucocorticoids for treatment of SRMA relapses in 12 dogs on a retrospective basis.
METHODS
Dogs with recurrent episodes of SRMA and treated with a combination of CA and prednisolone were included. Information about clinical course, treatment response and adverse events was collected from medical records. Ethical approval was not required for this study.
RESULTS
Ten dogs (10/12) responded well to the treatment with clinical signs being completely controlled. One dog is in clinical remission, but still under treatment. One dog (8%) showed further relapse. Mean treatment period was 51 weeks. Adverse events of variable severity (grade 1-4/5) were documented in all dogs during treatment according to the veterinary cooperative oncology group grading. Three dogs developed severe adverse events. Laboratory findings showed marked changes up to grade 4. Diarrhoea and anaemia were the most often observed adverse events (6), followed by dermatitis (4), alopecia (3) and pneumonia (3). Including blood chemistry changes (13), 50 adverse events were found in total.
CONCLUSION
Treatment with CA and glucocorticoids resulted in clinical remission in 10/12 dogs, but a high incidence of adverse events occurred requiring additional measures. All adverse events could be managed successfully in all cases.
背景
类固醇反应性脑膜炎-动脉炎（SRMA）的复发较为常见，但针对这一问题的具体治疗方案却鲜有报道。标准治疗包括长时间使用糖皮质激素单药或联合免疫抑制剂治疗。本研究旨在回顾性评估阿糖胞苷（CA）联合糖皮质激素治疗 12 例犬 SRMA 复发的安全性和疗效。
方法
纳入复发性 SRMA 并接受 CA 和泼尼松龙联合治疗的犬。从病历中收集有关临床病程、治疗反应和不良事件的信息。本研究无需伦理批准。
结果
10 只犬（10/12）对治疗有良好反应，临床症状完全得到控制。1 只犬仍在临床缓解期，但仍在治疗中。1 只犬（8%）出现进一步复发。平均治疗期为 51 周。根据兽医肿瘤协作组分级，所有犬在治疗期间均出现不同严重程度（1-4/5 级）的不良事件。3 只犬出现严重不良事件。实验室检查结果显示，高达 4 级的显著变化。腹泻和贫血是最常见的不良事件（6 例），其次是皮炎（4 例）、脱毛（3 例）和肺炎（3 例）。包括血液化学变化（13 例），共发现 50 例不良事件。
结论
CA 和糖皮质激素治疗使 12 只犬中的 10 只达到临床缓解，但不良事件发生率较高，需要采取额外措施。所有不良事件均可成功治疗。
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