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替米沙坦作为难治性特发性癫痫犬的附加治疗:一项非随机、非对照、开放标签的临床试验。

Telmisartan as an add-on treatment for dogs with refractory idiopathic epilepsy: a nonrandomized, uncontrolled, open-label clinical trial.

机构信息

Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.

Blue Pearl Veterinary Partners, New York, NY.

出版信息

J Am Vet Med Assoc. 2022 Feb 24;260(7):735-740. doi: 10.2460/javma.20.12.0683.

Abstract

OBJECTIVE

To evaluate the effect on seizure frequency of add-on telmisartan treatment in dogs with refractory idiopathic epilepsy.

ANIMALS

11 client-owned dogs with idiopathic epilepsy and ≥ 2 generalized seizures/mon that were currently being treated with ≥ 2 antiepileptic drugs.

PROCEDURES

Telmisartan was administered at a dosage of 0.25 to 1 mg/kg, PO, every 12 hours for 4 to 16 months. Seizure frequencies before and during telmisartan treatment were recorded.

RESULTS

10 dogs completed the 4-month treatment protocol. One dog was excluded owing to a transient increase in serum creatinine concentration; no adverse effects of telmisartan were observed in the remaining 10 dogs. A reduction in seizure frequency greater than an estimated expected placebo effect of 30% was evident in 7 of the 10 dogs. Long-term (12 to 16 months) follow-up information was available for 6 dogs, of which 4 had a further reduction in seizure frequency. Differences in seizure frequency were not statistically significant. No significant difference was found in serum phenobarbital concentration throughout the treatment period in the 7 dogs that were tested.

CLINICAL RELEVANCE

Telmisartan has the potential to reduce seizure frequency when administered as an add-on antiepileptic drug in dogs with refractory idiopathic epilepsy. A randomized, double-blind, placebo-controlled trial is needed to determine the true efficacy of telmisartan. On the basis of our results, a sample size of 54 dogs with refractory idiopathic epilepsy would be needed.

摘要

目的

评估添加替米沙坦治疗对难治性特发性癫痫犬癫痫发作频率的影响。

动物

11 只特发性癫痫伴≥2 次全身性发作/月的患犬,目前正在用≥2 种抗癫痫药物治疗。

方法

替米沙坦按 0.25 至 1 mg/kg、PO、每 12 小时 1 次的剂量给药,连续 4 至 16 个月。记录替米沙坦治疗前后的癫痫发作频率。

结果

10 只犬完成了 4 个月的治疗方案。1 只犬因血清肌酐浓度短暂升高而被排除;其余 10 只犬未观察到替米沙坦的不良反应。10 只犬中有 7 只癫痫发作频率降低大于预计的安慰剂效应 30%。6 只犬可获得 12 至 16 个月的长期随访信息,其中 4 只犬癫痫发作频率进一步降低。差异无统计学意义。在接受检测的 7 只犬中,整个治疗期间血清苯巴比妥浓度无显著差异。

临床相关性

替米沙坦作为添加型抗癫痫药物用于治疗难治性特发性癫痫犬,具有降低癫痫发作频率的潜力。需要进行随机、双盲、安慰剂对照试验来确定替米沙坦的真实疗效。根据我们的结果,需要 54 只难治性特发性癫痫犬的样本量。

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