Retrospective evaluation of leflunomide as an adjunctive therapy in dogs with non-associative immune-mediated thrombocytopenia: 20 cases (2008-2021)

IF 1.7 2区 农林科学 Q2 VETERINARY SCIENCES Journal of Small Animal Practice Pub Date : 2024-03-03 DOI:10.1111/jsap.13715
D. J. Spear, Z. J. Crouse, S. A. Kearns
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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.

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来氟米特作为辅助疗法治疗非关联性免疫介导血小板减少症狗的回顾性评估:20 个病例(2008-2021 年)。
目的描述来氟米特作为治疗非关联性免疫介导的血小板减少症的辅助疗法:对2008年3月至2021年9月使用来氟米特治疗确诊为非关联性免疫介导的血小板减少症的犬只进行回顾性研究。收集的数据包括信号、临床症状、体格检查结果和进行的诊断测试。记录了来氟米特治疗期间的用药情况、住院时间、血小板浓度>150×109 /L的时间以及不良反应。报告了确诊后一年内的复发情况:共有 20 只客户饲养的狗符合纳入标准。20只狗中有19只(95%)在来氟米特和泼尼松联合治疗后血小板浓度达到150×109 /L以上,4只狗(21.1%)在治疗期间或治疗后不久复发。不良反应包括腹泻(5 只)、轻度淋巴细胞减少(9 只)和轻度间歇性贫血(1 只)。有一只狗出现了肝毒性,推测是继发于来氟米特治疗,停药后症状缓解。一只狗在治疗期间因吸入性肺炎接受了治疗。两只狗在接受来氟米特治疗期间被安乐死:住院时间、血小板恢复时间、治疗反应和复发率与其他治疗方案相当。大多数不良反应不需要调整来氟米特的剂量;但有两只狗在接受来氟米特治疗期间死亡,而且有确凿证据表明,其中一只狗因免疫抑制而继发致命感染。肝毒性仍然是来氟米特治疗的一种已知并发症,建议进行连续的生化检测。
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来源期刊
Journal of Small Animal Practice
Journal of Small Animal Practice 农林科学-兽医学
CiteScore
3.30
自引率
6.20%
发文量
117
审稿时长
12-24 weeks
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
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