PDF(Pubmed)
Abstract：
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.
摘要：
锑酸盐治疗，与别嘌醇有关，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与aNm治疗CanL相关的潜在不良反应，并旨在研究其疗效。回顾性研究回顾了87只患有CanL的狗的记录，在治疗期间或结束时至少进行了一次随访，每天两次皮下给予50mg/kg剂量的aNm（Glucantime®）与别嘌呤醇。总的来说,29.8％的狗在治疗期间表现为注射部位的局部反应（n=6），对疼痛（源自接种部位）的严重全身反应，伴有抑郁和厌食症（n=4），肾功能恶化引起的全身性疾病（n=4），急性胰腺炎（n=1），腹泻（n=5），呕吐（n=3）和严重的特异性皮肤反应（n=3）。这些狗,13(14.9%)需要暂停治疗。这项前瞻性研究包括16只狗，在LeishVetII期和III期CKDIRIS1期(国际肾脏权益协会犬慢性肾脏病分期)中选择,并采用与回顾性研究中相同的aNm加别嘌呤醇方案治疗,观察了360天;2只狗因注射部位出现严重反应而被排除在外.在其他4只狗中报告了轻度和短暂的不良事件。用于评估aNm治疗疗效的标准如下：临床评分降低，实验室参数改善和/或正常化，PCR阴性对骨髓样本和无病间隔时间。在D180时,临床评分降低的比例达到91.9%。在整个研究期间，没有动物表现出临床实验室复发，有趣的是，PCR结果显示78.5%的动物在D0和D60之间完全阴性。兽医必须对与aNm相关的潜在严重不良反应保持警惕，并在出现意外临床表现时立即停止给药。另一方面,他们不应该放弃其在CanL治疗中的用途，因为已证实aNm与别嘌呤醇联合在控制CanL方面非常有效。
