Digiaro Serena, Recchia Alessandra, Colella Antonella, Cucciniello Sara, Greco Beatrice, Buonfrate Dora, Paradies Paola
Department DiMePre-J, Veterinary Section, University of Bari "Aldo Moro", Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy.
Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
Animals (Basel). 2024 Aug 1;14(15):2244. doi: 10.3390/ani14152244.
Antimoniate therapy, in association with allopurinol, is one of the first-line treatments of canine leishmaniasis (CanL). This study evaluates the potential adverse effects associated with aNm in the treatment of CanL through both a retrospective analysis and a long-term prospective study also aimed to investigate its efficacy. The retrospective study reviewed records of 87 dogs with CanL with at least one follow-up available during or at the end of therapy with aNm (Glucantime) at a dose of 50 mg/kg administered subcutaneously twice a day in association with allopurinol. In total, 29.8% of dogs showed adverse effects during treatment as local reactions at the injection site (n = 6), severe systemic reaction to pain (originating from the inoculation site) with depression and anorexia (n = 4), systemic disease due to renal function worsening (n = 4), acute pancreatitis (n = 1), diarrhea (n = 5), vomiting (n = 3) and severe idiosyncratic skin reactions (n = 3). Of these dogs, 13 (14.9%) required treatment suspension. The prospective study included 16 dogs, selected among the LeishVet stages II and III CKD IRIS stage 1 (International Renal Interest Society staging of canine Chronic Kidney Disease) and treated with the same aNm plus allopurinol protocol as in the retrospective study and observed for 360 days; 2 dogs were excluded for severe reactions at the injection site. Mild and transient adverse events were reported in the other 4 dogs. The criteria used to evaluate the efficacy of treatment with aNm were as follows: a reduction in the clinical score and improvement and/or normalization of laboratory parameters, negativization of PCR on the bone marrow samples and disease-free interval time. The proportion of reduction in the clinical score reached 91.9% at D180. No animals showed clinical laboratory relapse during the whole study duration and interestingly, the PCR results showed complete negativity between D0 and D60 in 78.5% of animals. Veterinarians must be vigilant regarding the potentially serious adverse effects associated with aNm and promptly stop drug administration if unexpected clinical manifestations occur. On the other hand, they should not discard its use for CanL treatment since it is confirmed that aNm in association with allopurinol is highly effective in controlling CanL.
锑剂疗法联合别嘌醇是犬利什曼病（CanL）的一线治疗方法之一。本研究通过回顾性分析和长期前瞻性研究评估了葡糖酸锑钠（aNm）治疗CanL时的潜在不良反应，该前瞻性研究还旨在调查其疗效。回顾性研究回顾了87只CanL犬的记录，这些犬在接受aNm（葡糖酸锑钠）治疗期间或治疗结束时至少有一次随访，aNm剂量为50mg/kg，皮下注射，每天两次，联合别嘌醇。总共有29.8%的犬在治疗期间出现不良反应，表现为注射部位的局部反应（n = 6）、对疼痛的严重全身反应（源于接种部位）伴抑郁和厌食（n = 4）、因肾功能恶化导致的全身性疾病（n = 4）、急性胰腺炎（n = 1）、腹泻（n = 5）、呕吐（n = 3）和严重的特异质性皮肤反应（n = 3）。在这些犬中，13只（14.9%）需要暂停治疗。前瞻性研究纳入了16只犬，这些犬选自利什曼病兽医协会（LeishVet）II期和III期慢性肾脏病（CKD）国际肾脏利益协会（IRIS）1期（犬慢性肾脏病的国际肾脏利益协会分期），并采用与回顾性研究相同的aNm加别嘌醇方案进行治疗，观察360天；2只犬因注射部位出现严重反应而被排除。另外4只犬报告了轻微和短暂的不良事件。用于评估aNm治疗效果的标准如下：临床评分降低、实验室参数改善和/或正常化、骨髓样本PCR转阴以及无病间隔时间。在第180天时，临床评分降低的比例达到91.9%。在整个研究期间，没有动物出现临床实验室复发，有趣的是，PCR结果显示78.5%的动物在第0天至第60天之间完全转阴。兽医必须警惕与aNm相关的潜在严重不良反应，如果出现意外的临床表现，应立即停止给药。另一方面，他们不应放弃将其用于CanL治疗，因为已证实aNm联合别嘌醇在控制CanL方面非常有效。
