{"title":"Retrospective evaluation of leflunomide as an adjunctive therapy in dogs with non-associative immune-mediated thrombocytopenia: 20 cases (2008-2021)","authors":"D. J. Spear, Z. J. Crouse, S. A. Kearns","doi":"10.1111/jsap.13715","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To describe leflunomide as an adjunctive therapy in the treatment of non-associative immune-mediated thrombocytopenia.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>A retrospective study of dogs with a diagnosis of non-associative immune-mediated thrombocytopenia treated with leflunomide March 2008 to September 2021 was conducted. Data collected included signalment, clinical signs, physical examination findings and diagnostic testing performed. Medications administered, duration of hospital stay, time to platelet concentration >150×10<sup>9</sup>/L and adverse events during leflunomide therapy were recorded. Relapses within a year of diagnosis were reported.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 20 client-owned dogs met inclusion criteria. Nineteen of 20 dogs (95%) achieved a platelet concentration >150×10<sup>9</sup>/L with leflunomide and prednisone combination therapy and four dogs (21.1%) relapsed during treatment or shortly after treatment. Adverse effects included diarrhoea (n=5), mild lymphopenia (n=9) and mild intermittent anaemia (n=1). A single dog developed hepatotoxicity presumed to be secondary to leflunomide therapy that resolved after drug discontinuation. One dog was treated for aspiration pneumonia during treatment. Two dogs were euthanased while receiving leflunomide.</p>\n </section>\n \n <section>\n \n <h3> Clinical Significance</h3>\n \n <p>Length of hospitalisation, time to platelet recovery, treatment response and relapse rate were comparable with alternative treatment protocols. Most adverse effects did not require leflunomide dose adjustment; however, two dogs died while undergoing leflunomide treatment and there is compelling evidence that one of these dogs experienced fatal infection secondary to immune-suppression. Hepatotoxicity remains a known complication of leflunomide treatment and serial biochemistry testing is recommended.</p>\n </section>\n </div>","PeriodicalId":17062,"journal":{"name":"Journal of Small Animal Practice","volume":"65 4","pages":"261-269"},"PeriodicalIF":1.7000,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Small Animal Practice","FirstCategoryId":"97","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jsap.13715","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To describe leflunomide as an adjunctive therapy in the treatment of non-associative immune-mediated thrombocytopenia.
Materials and Methods
A retrospective study of dogs with a diagnosis of non-associative immune-mediated thrombocytopenia treated with leflunomide March 2008 to September 2021 was conducted. Data collected included signalment, clinical signs, physical examination findings and diagnostic testing performed. Medications administered, duration of hospital stay, time to platelet concentration >150×109/L and adverse events during leflunomide therapy were recorded. Relapses within a year of diagnosis were reported.
Results
A total of 20 client-owned dogs met inclusion criteria. Nineteen of 20 dogs (95%) achieved a platelet concentration >150×109/L with leflunomide and prednisone combination therapy and four dogs (21.1%) relapsed during treatment or shortly after treatment. Adverse effects included diarrhoea (n=5), mild lymphopenia (n=9) and mild intermittent anaemia (n=1). A single dog developed hepatotoxicity presumed to be secondary to leflunomide therapy that resolved after drug discontinuation. One dog was treated for aspiration pneumonia during treatment. Two dogs were euthanased while receiving leflunomide.
Clinical Significance
Length of hospitalisation, time to platelet recovery, treatment response and relapse rate were comparable with alternative treatment protocols. Most adverse effects did not require leflunomide dose adjustment; however, two dogs died while undergoing leflunomide treatment and there is compelling evidence that one of these dogs experienced fatal infection secondary to immune-suppression. Hepatotoxicity remains a known complication of leflunomide treatment and serial biochemistry testing is recommended.
期刊介绍:
Journal of Small Animal Practice (JSAP) is a monthly peer-reviewed publication integrating clinical research papers and case reports from international sources, covering all aspects of medicine and surgery relating to dogs, cats and other small animals. These papers facilitate the dissemination and implementation of new ideas and techniques relating to clinical veterinary practice, with the ultimate aim of promoting best practice. JSAP publishes high quality original articles, as well as other scientific and educational information. New developments are placed in perspective, encompassing new concepts and peer commentary. The target audience is veterinarians primarily engaged in the practise of small animal medicine and surgery.
In addition to original articles, JSAP will publish invited editorials (relating to a manuscript in the same issue or a topic of current interest), review articles, which provide in-depth discussion of important clinical issues, and other scientific and educational information from around the world.
The final decision on publication of a manuscript rests with the Editorial Board and ultimately with the Editor. All papers, regardless of type, represent the opinion of the authors and not necessarily that of the Editor, the Association or the Publisher.
The Journal of Small Animal Practice is published on behalf of the British Small Animal Veterinary Association and is also the official scientific journal of the World Small Animal Veterinary Association