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Homedes J, Ocak M, Riedle S, Salichs M. A blinded, randomized and controlled multicenter field study investigating the safety and efficacy of long-term use of enflicoxib in the treatment of naturally occurring osteoarthritis in client-owned dogs. Front Vet Sci 2024; 11:1349901. [PMID: 38585299 PMCID: PMC10995975 DOI: 10.3389/fvets.2024.1349901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/13/2024] [Indexed: 04/09/2024] Open
Abstract
Background Enflicoxib is a COX-2 selective NSAID shown to be efficacious and safe in the treatment of pain and inflammation associated with canine osteoarthritis (OA) in clinical studies of 6 weeks duration. Objective This prospective, multisite, blinded, randomized, placebo-controlled, parallel-group field study aimed to confirm the safety and efficacy of enflicoxib in long-term canine OA treatments. Animals A total of 109 client owned dogs with clinical and radiographic signs of OA for at least 3 weeks were enrolled with 78 dogs completing all study visits. Methods Dogs were randomized at a 3:1 ratio to receive enflicoxib (n = 83) or placebo (n = 26) once weekly during 6 months. Dogs underwent veterinary assessments from Day 0 to Day 189 using a clinical sum score (CSS). Efficacy was also assessed by the owners using the Canine Brief Pain Inventory (CBPI). Safety was assessed clinically and by repeated blood and urine sample analysis. The efficacy outcome measure was the treatment response according to the CSS and secondarily the treatment response according to the CBPI. The primary safety outcome was the incidence of adverse events (AEs) and secondarily the evolution of the clinical pathology parameters. Results Percentages of CSS responders for enflicoxib were 71.6; 74.6 and 71.6% on Days 44, 135 and 189 respectively, always showing statistically significant differences (p < 0.05) vs. placebo (41.7, 33.3, and 20.8% respectively). Treatment response according to owner assessments followed the same pattern, achieving significant differences compared to placebo after 2 weeks of treatment. The incidence and type of AEs were as described in previous enflicoxib studies of shorter duration and as for other NSAIDs, with no tendency to increase over time. No relevant changes in hematology, biochemistry or urine parameters were observed. Conclusions and clinical relevance Enflicoxib safety and efficacy profile is maintained after a long-term treatment, which together with its weekly administration, makes it a good alternative for the chronic treatment of dogs with naturally occurring OA.
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Affiliation(s)
- Josep Homedes
- Ecuphar Veterinaria SLU (Animalcare Group) Sant Cugat del Vallès, Barcelona, Spain
| | | | | | - Marta Salichs
- Ecuphar Veterinaria SLU (Animalcare Group) Sant Cugat del Vallès, Barcelona, Spain
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2
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Shilo-Benjamini Y, Lavy E, Yair N, Milgram J, Zilbersheid D, Hod A, Barasch D, Abu Ahmad W, Cern A, Barenholz Y. Therapeutic efficacy and pharmacokinetics of liposomal-cannabidiol injection: a pilot clinical study in dogs with naturally-occurring osteoarthritis. Front Vet Sci 2023; 10:1224452. [PMID: 37680386 PMCID: PMC10481162 DOI: 10.3389/fvets.2023.1224452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Osteoarthritis is a common disease in dogs resulting in chronic pain and decreased wellbeing. Common analgesics such as non-steroidal anti-inflammatories may fail to control pain and can produce major adverse effects. Study objectives were to evaluate pharmacokinetics, therapeutic efficacy, and safety of subcutaneous liposomal-cannabidiol (CBD) as an additional analgesic therapy in dogs suffering from naturally-occurring osteoarthritis. Methods Six such dogs were recruited following ethics approval and owner consent. Dogs were administered a single subcutaneous injection of 5 mg/kg liposomal-CBD. Plasma concentrations of CBD, blood work, activity monitoring collar data, wellbeing questionnaire (owners) and pain scoring (veterinarian) were performed at baseline and monitored up to six weeks following intervention. Data overtime were compared with baseline using linear-regression mixed-effects. P-value was set at 0.05. Results CBD plasma concentrations were observed for 6 weeks; median (range) peak plasma concentration (Cmax) was 45.2 (17.8-72.5) ng/mL, time to Cmax was 4 (2-14) days and half-life was 12.4 (7.7-42.6) days. Median (range) collar activity score was significantly increased on weeks 5-6; from 29 (17-34) to 34 (21-38). Scores of wellbeing and pain evaluations were significantly improved at 2-3 weeks; from 69 (52-78) to 53.5 (41-68), and from 7.5 (6-8) to 5.5 (5-7), respectively. The main adverse effect was minor local swelling for several days in 5/6 dogs. Conclusion Liposomal-CBD administered subcutaneously produced detectable CBD plasma concentrations for 6 weeks with minimal side effects and demonstrated reduced pain and increased wellbeing as part of multimodal pain management in dogs suffering from osteoarthritis. Further placebo-controlled studies are of interest.
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Affiliation(s)
- Yael Shilo-Benjamini
- Department of Biochemistry, Hadassah Medical School, Laboratory of Membrane and Liposome Research, The Hebrew University of Jerusalem, Jerusalem, Israel
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Eran Lavy
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Nadav Yair
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Joshua Milgram
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Daniel Zilbersheid
- Department of Biochemistry, Hadassah Medical School, Laboratory of Membrane and Liposome Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atara Hod
- Department of Biochemistry, Hadassah Medical School, Laboratory of Membrane and Liposome Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dinorah Barasch
- The Mass Spectrometry Unit, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Wiessam Abu Ahmad
- Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ahuva Cern
- Department of Biochemistry, Hadassah Medical School, Laboratory of Membrane and Liposome Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yechezkel Barenholz
- Department of Biochemistry, Hadassah Medical School, Laboratory of Membrane and Liposome Research, The Hebrew University of Jerusalem, Jerusalem, Israel
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Pye C, Bruniges N, Peffers M, Comerford E. Advances in the pharmaceutical treatment options for canine osteoarthritis. J Small Anim Pract 2022; 63:721-738. [PMID: 35285032 PMCID: PMC9790257 DOI: 10.1111/jsap.13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/25/2021] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
Canine osteoarthritis is a significant cause of pain in many dogs and can therefore compromise animal welfare. As the understanding of the biology and pain mechanisms underpinning osteoarthritis grows, so do the number of treatments available to manage it. Over the last decade, there have been a number of advances in the pharmaceutical treatment options available for dogs with osteoarthritis, as well as an increasing number of clinical trials investigating the efficacy of pre-existing treatments. This review aims to examine the current evidence behind pharmaceutical treatment options for canine osteoarthritis, including non-steroidal anti-inflammatory drugs, piprants, monoclonal antibodies, adjunctive analgesics, structure modifying osteoarthritis drugs and regenerative therapies.
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Affiliation(s)
- C. Pye
- Institute of Life Course and Medical Sciences, Faculty of Health and Life SciencesUniversity of LiverpoolWilliam Henry Duncan Building, 6 West Derby StreetLiverpoolL7 8TXUK
| | - N. Bruniges
- University of Liverpool Small Animal Teaching HospitalUniversity of LiverpoolLeahurst Campus, Chester High RoadNestonCH64 7TEUK
| | - M. Peffers
- Institute of Life Course and Medical Sciences, Faculty of Health and Life SciencesUniversity of LiverpoolWilliam Henry Duncan Building, 6 West Derby StreetLiverpoolL7 8TXUK
| | - E. Comerford
- Institute of Life Course and Medical Sciences, Faculty of Health and Life SciencesUniversity of LiverpoolWilliam Henry Duncan Building, 6 West Derby StreetLiverpoolL7 8TXUK
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4
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Shilo-Benjamini Y, Cern A, Zilbersheid D, Hod A, Lavy E, Barasch D, Barenholz Y. A Case Report of Subcutaneously Injected Liposomal Cannabidiol Formulation Used as a Compassion Therapy for Pain Management in a Dog. Front Vet Sci 2022; 9:892306. [PMID: 35573415 PMCID: PMC9097221 DOI: 10.3389/fvets.2022.892306] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
A 14-year-old intact mixed breed dog (26 kg) was submitted for a novel cannabidiol (CBD) analgesic treatment. The dog was cachectic and had a testicular neoplasia, hip and elbow osteoarthritis and severe cervical pain. Analgesic treatment included canine osteoarthritic supplement, robencoxib and gabapentin. An additional liposomal CBD injectable formulation at 5 mg/kg was administered subcutaneously between the shoulder blades. The dog was monitored using an activity monitoring collar (PetPace), owner wellbeing questionnaire (Canine Brief Pain Inventory; CBPI), pain interactive visual analog scale (iVAS), blood work and CBD plasma concentrations. A week from the injection and up to 3 weeks afterwards the dog had improved CBPI and iVAS pain scores, and increased collar activity scores. CBD was quantified in plasma for 28 days. Due to disease progression, further difficulty to rise and walk, and relapse to pain after 3 weeks, the owners requested a second liposomal CBD injection, which was performed 4 weeks following the first injection using 3 mg/kg dose. Two days later, the dog was found dead in the yard under direct sun, while environmental temperature was 37°C. Major findings on necropsy revealed evidence of heat stroke and severe cervical disc protrusion with spinal hematoma, none related to liposomal CBD. In conclusion, subcutaneous liposomal CBD produced quantifiable CBD plasma concentrations for 28 days and may be an effective additional treatment as part of multimodal pain management in dogs.
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Affiliation(s)
- Yael Shilo-Benjamini
- Laboratory of Membrane and Liposome Research, Department of Biochemistry, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
- *Correspondence: Yael Shilo-Benjamini
| | - Ahuva Cern
- Laboratory of Membrane and Liposome Research, Department of Biochemistry, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel Zilbersheid
- Laboratory of Membrane and Liposome Research, Department of Biochemistry, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atara Hod
- Laboratory of Membrane and Liposome Research, Department of Biochemistry, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eran Lavy
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dinorah Barasch
- The Mass Spectrometry Unit, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yechezkel Barenholz
- Laboratory of Membrane and Liposome Research, Department of Biochemistry, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
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Lees P, Toutain PL, Elliott J, Giraudel JM, Pelligand L, King JN. Pharmacology, safety, efficacy and clinical uses of the COX-2 inhibitor robenacoxib. J Vet Pharmacol Ther 2022; 45:325-351. [PMID: 35460083 PMCID: PMC9541287 DOI: 10.1111/jvp.13052] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 12/14/2022]
Abstract
Robenacoxib is a veterinary‐approved non‐steroidal anti‐inflammatory drug (NSAID) of the coxib group. It possesses anti‐hyperalgesic, anti‐inflammatory and anti‐pyretic properties. Robenacoxib inhibits the cyclooxygenase (COX)‐2 isoform of COX selectively (in vitro IC50 ratios COX‐1:COX‐2, 129:1 in dogs, 32:1 in cats). At registered dosages (2 mg/kg subcutaneously in dogs and cats, 1–4 mg/kg orally in dogs and 1–2.4 mg/kg orally in cats), robenacoxib produces significant inhibition of COX‐2 whilst sparing COX‐1. The pharmacokinetic (PK) profile of robenacoxib is characterized by a high degree of binding to plasma proteins (>98%) and moderate volume of distribution (at steady state, 240 ml/kg in dogs and 190 ml/kg in cats). In consequence, the terminal half‐life in blood (<2 h) is short, despite moderate body clearance (0.81 L/kg/h) in dogs and low clearance (0.44 L/kg/h) in cats. Excretion is principally in the bile (65% in dogs and 72% in cats). Robenacoxib concentrates in inflamed tissues, and clinical efficacy is achieved with once‐daily dosing, despite the short blood terminal half‐life. In dogs, no relevant breed differences in robenacoxib PK have been detected. Robenacoxib has a wide safety margin; in healthy laboratory animals daily oral doses 20‐fold (dog, 1 month), eight‐fold (cat, 6 weeks) and five‐fold (dog, 6 months) higher than recommended clinical doses were well tolerated. Clinical efficacy and safety have been demonstrated in orthopaedic and soft tissue surgery, and in musculoskeletal disorders in dogs and cats.
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Affiliation(s)
- Peter Lees
- Royal Veterinary College, University of London, London, UK
| | - Pierre-Louis Toutain
- Royal Veterinary College, University of London, London, UK.,INTHERES, INRA, ENVT, Université de Toulouse, Toulouse, France
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Whittem T, Richards L, Alexander J, Beck C, Knight C, Milne M, Rockman M, Saunders R, Tyrrell D. A randomised controlled masked clinical trial of two treatments for osteoarthritis in dogs. Aust Vet J 2021; 99:267-272. [PMID: 33904159 DOI: 10.1111/avj.13066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
The product 4CYTE™ Canine (Interpath Pty Ltd., Ballarat, Victoria, Australia) contains four active ingredients: three marine-derived ingredients and Epiitalis®, which is extracted from the seed of the plant Biota orientalis. Carprofen is a non-steroidal anti-inflammatory drug (NSAID) licensed for the treatment of osteoarthritis in dogs and is the active ingredient in several licensed products. This study aimed to compare the efficacy of 4CYTE Canine with carprofen for the treatment of pain from osteoarthritis. The trial was a randomised, masked, parallel group trial in dogs with naturally occurring osteoarthritis. Sixty-nine dogs with body weight of between 10 and 50 kg were enrolled in the study, of which 66 (95.7%) completed the study. The 4CYTE Canine was administered at 60 mg active/kg daily and carprofen at 2-4 mg/kg daily, with a loading dose of up to 4 mg/kg on the first day. The trial duration was 28 days. The primary outcome was defined as improvement in Owner Lameness Score at Day 28 compared with Day 0. Other outcomes measured included Veterinary Lameness Scores and the Owner Mobility Scores. At Day 28, 14 of 29 (48.3%) dogs that received 4CYTE Canine and 13 of 37 (35.1%) dogs that received carprofen had improved. The 4CYTE Canine was found to be non-inferior to carprofen at Day 14 for the Owner Mobility Score and at Day 28 for all three outcomes. This response pattern suggests that improvement in response to 4CYTE Canine continued between Days 14 and 28. These results support the conclusion that 4CYTE Canine is not inferior to carprofen by end-point clinical efficacy.
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Affiliation(s)
- T Whittem
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - L Richards
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - J Alexander
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Beck
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Knight
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - M Milne
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - M Rockman
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Saunders
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - D Tyrrell
- Translational Research and Animal Clinical Trials (TRACTs) group, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Pavarotti GS, Hivernaud V, Brincin M, Roche R, Barreau P, Festy F, Gauthier O. Evaluation of a Single Intra-Articular Injection of Autologous Adipose Tissue for the Treatment of Osteoarthritis: A Prospective Clinical Study in Dogs. Vet Comp Orthop Traumatol 2020; 33:258-266. [PMID: 32316062 DOI: 10.1055/s-0040-1708524] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the safety, feasibility and clinical efficacy of a single intra-articular injection of autologous and purified micro-fragmented adipose tissue for the treatment of osteoarthritis (OA) in dogs. STUDY DESIGN Twenty-one client-owned dogs with radiographically confirmed OA were recruited into this prospective study. Lameness and discomfort were evaluated by physical examination at day 0 and then 14, 30, 60 and 180 days after injection. Kinetic data and temporospatial parameters were obtained using a pressure-sensing walkway. Peak vertical force, vertical impulse and percentages of body weight distribution were determined. Owner perception data regarding their own dog's physical activity were also collected using the Canine Brief Pain Inventory. RESULTS Radiographic scores for OA from days 0 to 180 were similar, except in two dogs. No major side effects were noted after injection. Lameness and Canine Brief Pain Inventory scores were significantly lower at all time points compared with day 0. Post-injection results demonstrated gradual improvement of kinetic data up to day 180 compared with pre-treatment values: vertical impulse (>2.25%), peak vertical force (>5.32%) and percentages of body weight distribution (>3.6%). In dogs with elbow OA, gait analysis values significantly increased at all time points compared with day 0. CONCLUSION Regenerative autologous adipose tissue injection therapy is a promising alternative to traditional analgesics treatment in patients with OA, associated with significant reductions in pain and lameness, delayed disease progression and improved quality of life.
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Affiliation(s)
- Greta S Pavarotti
- Department of Small Animal Surgery and Anesthesia, ONIRIS Nantes Atlantic College of Veterinary Medicine, Nantes, France
| | - Vincent Hivernaud
- Stemcis Cyroi, 2 rue Maxime Rivière, 97490 Ste Clotilde, Ste Clotilde, France
| | - Mélanie Brincin
- Department of Small Animal Surgery and Anesthesia, ONIRIS Nantes Atlantic College of Veterinary Medicine, Nantes, France
| | - Régis Roche
- Stemcis Cyroi, 2 rue Maxime Rivière, 97490 Ste Clotilde, Ste Clotilde, France
| | - Pierre Barreau
- Department of Small Animal Surgery and Anesthesia, ONIRIS Nantes Atlantic College of Veterinary Medicine, Nantes, France
| | - Franck Festy
- Stemcis Cyroi, 2 rue Maxime Rivière, 97490 Ste Clotilde, Ste Clotilde, France
| | - Olivier Gauthier
- Department of Small Animal Surgery and Anesthesia, ONIRIS Nantes Atlantic College of Veterinary Medicine, Nantes, France
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Budsberg SC, Kleine SA, Norton MM, Sandberg GS. Comparison of two inhibitors of E-type prostanoid receptor four and carprofen in dogs with experimentally induced acute synovitis. Am J Vet Res 2020; 80:1001-1006. [PMID: 31644340 DOI: 10.2460/ajvr.80.11.1001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the ability of a proprietary antagonist of E-type prostanoid receptor (EP) 4, grapiprant, and carprofen to attenuate lameness attributable to urate-induced synovitis in dogs. ANIMALS 5 purpose-bred hound-cross dogs. PROCEDURES A blinded, 3-way crossover study was performed. Dogs received each of 3 treatments (L-766, a proprietary antagonist of EP4; 4.0 mg/kg), grapiprant (an antagonist of EP4; 2.0 mg/kg), and carprofen (4.4 mg/kg); dogs received 4 doses of each treatment (14 and 2 hours before and 22 and 46 hours after urate injection). Synovitis was induced by intra-articular injection of sodium urate. Measurements (vertical ground reaction forces and clinical lameness scores) were obtained immediately before (0 hours; baseline) and 6, 12, 24, 36, and 48 hours after sodium urate injection. All data were analyzed with repeated-measures ANOVA. RESULTS Lameness scores at 6 hours were significantly higher than baseline lameness scores for all treatments. Lameness scores for the grapiprant treatment remained significantly higher at 12 and 24 hours, compared with baseline lameness scores. Lameness scores for the carprofen treatment were significantly lower than lameness scores for the grapiprant treatment at 6, 12, and 24 hours. Analysis of peak vertical force and vertical impulse data revealed a pattern similar to that for lameness scores. Treatment with L-766 resulted in a significantly higher vertical impulse at 48 hours than did treatment with carprofen or grapiprant. CONCLUSIONS AND CLINICAL RELEVANCE In these dogs, carprofen was the most effective treatment for attenuating lameness induced by injection of sodium urate, and grapiprant was the least effective treatment.
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Ziegler AL, Blikslager AT. Sparing the gut: COX-2 inhibitors herald a new era for treatment of horses with surgical colic. EQUINE VET EDUC 2019; 32:611-616. [PMID: 34305336 DOI: 10.1111/eve.13189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage a wide variety of conditions in horses, including management of colic. Flunixin meglumine is by far the most commonly used drug in the control of colic pain and inflammation and has become a go-to for not only veterinarians but also horse-owners and nonmedical equine professionals. NSAID use, however, has always been controversial in critical cases due to a high risk of adverse effects associated with their potent cyclo-oxygenase (COX) inhibition. There are two important COX isoenzymes: COX-1 is generally beneficial for normal renal and gastrointestinal functions and COX-2 is associated with the pain and inflammation of disease. Newer selective NSAIDs can target COX-2-driven pathology while sparing important COX-1-driven physiology, which is of critical importance in horses with severe gastrointestinal disease. Emerging research suggests that firocoxib, a COX-2-selective NSAID labelled for use in horses, may be preferable for use in colic cases in spite of the decades-long dogma that flunixin saves lives.
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Affiliation(s)
- A L Ziegler
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.,Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - A T Blikslager
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
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Stabile M, Samarelli R, Trerotoli P, Fracassi L, Lacitignola L, Crovace A, Staffieri F. Evaluation of the Effects of Undenatured Type II Collagen (UC-II) as Compared to Robenacoxib on the Mobility Impairment Induced by Osteoarthritis in Dogs. Vet Sci 2019; 6:vetsci6030072. [PMID: 31487772 PMCID: PMC6789547 DOI: 10.3390/vetsci6030072] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 12/29/2022] Open
Abstract
Osteoarthritis (OA) is a chronic disease that requires a multimodal therapeutic approach. The aim of this study was to evaluate the effects of undenatured type II collagen (UC-II) as compared to robenacoxib in dogs affected by OA. Our hypothesis was that the two compounds would be similar (non-inferiority) in improving mobility. To test this hypothesis, a complete orthopedic examination, x-ray and the Liverpool Osteoarthritis in Dogs (LOAD) survey were performed in dogs affected by OA before and after the treatments. The study was designed as a clinical, randomized, controlled and prospective study. Sixty client-owned dogs were randomized in the R group (n = 30, robenacoxib 1 mg/kg/day for 30 days) and in the UC-II group (n = 30, UC-II 1 tablet/day for 30 days). Thirty days after the beginning of the treatment (T30), the dogs were reassessed for the LOAD, MOBILITY and CLINICAL scores. Based on the data obtained from the study, a significant reduction in LOAD and MOBILITY scores was recorded between T0 and T30 with a similar magnitude among the two groups (R = 31.5%, p < 0.001; UC-II = 32.7%, p = 0.013). The results of this study showed that UC-II and robenacoxib were able to similarly improve mobility of dogs affected by OA.
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Affiliation(s)
- Marzia Stabile
- Department of Emergency and Organ Transplantation, PhD in Tissues and Organs Transplantation and Cellular Therapies, University of Bari, 70010 Bari, Italy.
| | - Rossella Samarelli
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, University of Bari, 70010 Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70010 Bari, Italy
| | - Laura Fracassi
- Department of Emergency and Organ Transplantation, PhD in Tissues and Organs Transplantation and Cellular Therapies, University of Bari, 70010 Bari, Italy
| | - Luca Lacitignola
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, University of Bari, 70010 Bari, Italy
| | - Antonio Crovace
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, University of Bari, 70010 Bari, Italy
| | - Francesco Staffieri
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, University of Bari, 70010 Bari, Italy
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Oyama N, Sano T, Yamamori M, Tamura J, Umar MA, Endo Y, Ishikawa Y, Itoh A, Miyoshi K, Yamashita K. Influence of sevoflurane anesthesia with mechanical ventilation and fluid-therapy on distribution of subcutaneously administered robenacoxib in dogs. J Vet Med Sci 2018; 80:1450-1455. [PMID: 30078791 PMCID: PMC6160876 DOI: 10.1292/jvms.17-0356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Robenacoxib is a novel nonsteroidal anti-inflammatory drug approved for dogs. The present study aimed to evaluate influences of sevoflurane anesthesia on the distribution of robenacoxib in
dogs. Ten healthy beagle dogs (1 to 11 years old, 9.3 to 14.3 kg body weight, 6 males and 4 females) were subcutaneously administered robenacoxib (2 mg/kg) under conscious condition or
sevoflurane anesthesia inhaled a 1.3-fold predetermined individual minimum alveolar concentration of sevoflurane at a 28-day interval. The dogs under sevoflurane anesthesia were also
mechanically ventilated and received fluid-therapy. On each occasion, serum samples were collected from the dogs before and at 5, 15, 30, 60, 120, 180, and 240 min after the robenacoxib
administration. Serum robenacoxib concentration was measured by a liquid chromatography-tandem mass spectrometry. Maximum serum concentration of robenacoxib (Cmax) was 2.2
µg/ml [range: 1.2–4.6] (median [range: minimum-maximum]) and time of Cmax (Tmax) was 90 min [range: 60–120] in the conscious dogs.
In the sevoflurane-anesthetized dogs, the Cmax significantly declined (1.3 µg/ml [range: 0.8–1.4], P=0.008) and Tmax
was delayed (120 min [range: 120–240], P=0.018) compared with those in the conscious dogs. The serum robenacoxib concentration at 240 min (C240) decreased to 0.5
µg/ml [range: 0.2–0.9] in the conscious dogs, while it remained higher in the sevoflurane-anesthetized dogs (1.0 µg/ml
[range: 0.3–1.4], P=0.011). In conclusion, the anesthetic procedure with sevoflurane, mechanically ventilated, and received fluid-therapy might affect the pharmacokinetics
of subcutaneously administered robenacoxib in dogs.
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Affiliation(s)
- Norihiko Oyama
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Tadashi Sano
- Department of Veterinary Nursing Science, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Mizuki Yamamori
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Jun Tamura
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Mohammed Ahmed Umar
- Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State 600243, Nigeria
| | - Yusuke Endo
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Yusyun Ishikawa
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Akifumi Itoh
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Kenjirou Miyoshi
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Kazuto Yamashita
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
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Kongara K, Chambers JP. Robenacoxib in the treatment of pain in cats and dogs: safety, efficacy, and place in therapy. VETERINARY MEDICINE-RESEARCH AND REPORTS 2018; 9:53-61. [PMID: 30148083 PMCID: PMC6101027 DOI: 10.2147/vmrr.s170893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Robenacoxib is a novel nonsteroidal anti-inflammatory drug (NSAID) of coxib class developed for the control of inflammation and pain in dogs and cats. It shows high selectivity for the cyclooxygenase-2 (COX-2) enzyme in rats, cats, and dogs. Robenacoxib is available in both injectable and tablet formulations. This review initially focuses on the preclinical pharmacology of robenacoxib in rats that includes its high affinity for COX-2 enzyme and weaker and rapidly reversible binding for COX-1 enzyme in in vitro and ex vivo models of inflammation and its pharmacokinetics in the blood and inflammatory exudate, selective tissue distribution, and safety. These basic pharmacological profiles highlight the suitability of robenacoxib for use in target species, such as cats and dogs. Since the level of expression and activity of COX enzymes is species specific, COX-2-selective inhibition and the resultant effects of coxibs must be studied in target species. The pharmacological and toxicological profiles of robenacoxib in cats and dogs have been discussed prior to reviewing its clinical efficacy and safety. Large, multicenter field trials conducted in cats and dogs demonstrated the noninferior efficacy and safety of robenacoxib compared with noncoxib NSAIDs used in dogs and cats. These trials investigated the efficacy of robenacoxib against various acute and chronic painful conditions. Robenacoxib produced superior efficacy to placebo and COX-2 preferential inhibitors in postsurgical cats. The tissue-selective anti-inflammatory activity of robenacoxib has been demonstrated in dogs with osteoarthritis. Robenacoxib has also been shown to be safe in healthy dogs and cats receiving antihypertensive drugs and loop diuretics that could cause renal injury. The developmental objective of coxibs, comparable efficacy but superior safety to less selective/nonselective NSAIDs, is well established with robenacoxib in preclinical studies. More studies need to be conducted to fully explore the benefits of robenacoxib in clinical subjects.
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Affiliation(s)
- Kavitha Kongara
- Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, New Zealand,
| | - John Paul Chambers
- Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, New Zealand,
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13
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State of the art analgesia- recent developments in pharmacological approaches to acute pain management in dogs and cats. Part 1. Vet J 2018; 238:76-82. [DOI: 10.1016/j.tvjl.2018.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 01/11/2023]
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14
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Ziegler A, Fogle C, Blikslager A. Update on the use of cyclooxygenase-2-selective nonsteroidal anti-inflammatory drugs in horses. J Am Vet Med Assoc 2017; 250:1271-1274. [PMID: 28509650 DOI: 10.2460/javma.250.11.1271] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Nonsteroidal anti-inflammatory drugs work through inhibition of cyclooxygenase (COX) and are highly effective for the treatment of pain and inflammation in horses. There are 2 clinically relevant isoforms of COX. Cyclooxygenase-1 is constitutively expressed and is considered important for a variety of physiologic functions, including gastrointestinal homeostasis. Thus, NSAIDs that selectively inhibit COX-2 while sparing COX-1 may be associated with a lower incidence of adverse gastrointestinal effects. Various formulations of firocoxib, a COX-2-selective NSAID, labeled for use in horses are available in the United States. Equine practitioners should know that the FDA limits the use of firocoxib to formulations labeled for horses, regardless of price concerns. In addition, practitioners will benefit from understanding the nuances of firocoxib administration, including the importance of correct dosing and the contraindications of combining NSAIDs. Together with knowledge of the potential advantages of COX-2 selectivity, these considerations will help veterinarians select and treat patients that could benefit from this new class of NSAID.
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15
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Wang J, Zhao T, Kong J, Peng H, Lv P, Li J, Cao X, Zhang S. Determination of vitacoxib, a novel COX-2 inhibitor, in equine plasma using UPLC–MS/MS detection: Development and validation of new methodology. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1061-1062:270-274. [DOI: 10.1016/j.jchromb.2017.07.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/10/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
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16
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Teixeira LR, Luna SPL, Matsubara LM, Cápua MLB, Santos BPCR, Mesquita LR, Faria LG, Agostinho FS, Hielm-Björkman A. Owner assessment of chronic pain intensity and results of gait analysis of dogs with hip dysplasia treated with acupuncture. J Am Vet Med Assoc 2017; 249:1031-1039. [PMID: 27767433 DOI: 10.2460/javma.249.9.1031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate pain intensity and kinetic variables in dogs with hip dysplasia (HD) treated with acupuncture, carprofen, or a placebo. DESIGN Randomized, controlled clinical study. ANIMALS 54 HD-affected dogs and 16 healthy dogs. PROCEDURES Seven HD-affected dogs were removed from the study. Dogs with HD were treated in a blinded manner for 30 days with acupuncture (once weekly for 5 sessions; n = 15), carprofen (4.4 mg/kg [2.0 mg/lb], PO, q 24 h; n = 16), or placebo capsules containing lactose (1 mg/kg [0.45 mg/lb], PO, q 24 h; n = 16). Dogs were evaluated 2 weeks and immediately before (baseline) and 2, 4, and 6 weeks after the onset of treatment. Owners evaluated the dogs' pain intensity with 2 validated questionnaires and a visual analogue scale (VAS) for pain and evaluated degree of lameness with a VAS for locomotion. Kinetics of the hind limbs were also evaluated. Sixteen HD-free dogs were used to assess the evaluation protocol. RESULTS Owners' assessments revealed that outcomes of the 3 treatments did not differ significantly. The Canine Brief Pain Inventory and VAS pain intensity assessments were decreased from baseline at weeks 4 and 6, respectively, but only in acupuncture-treated dogs. The locomotion VAS values were decreased at week 4 in acupuncture-treated and carprofen-treated dogs. Kinetic evaluation findings did not differ among the groups or over time. CONCLUSIONS AND CLINICAL RELEVANCE Neither acupuncture nor carprofen was significantly different from placebo. Acupuncture and carprofen reduced the degree of subjectively evaluated lameness, and acupuncture was associated with a decrease in validated chronic pain scores.
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17
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Sawyere DM, Lanz OI, Dahlgren LA, Barry SL, Nichols AC, Werre SR. Cytokine and Growth Factor Concentrations in Canine Autologous Conditioned Serum. Vet Surg 2016; 45:582-6. [PMID: 27357270 DOI: 10.1111/vsu.12506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 04/25/2016] [Accepted: 04/29/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare cytokine and growth factor concentrations in canine autologous conditioned serum (ACS) to canine plasma. STUDY DESIGN Experimental in vivo study. ANIMALS Client-owned, adult dogs (n=22). METHODS Blood collected from 16 medium to large breed dogs was used to produce ACS (Orthokine(®) vet irap 10 syringes) and citrated plasma (control). Canine-specific ELISA assays were run per manufacturers' instructions for interleukin (IL)-10, IL-4, tumor necrosis factor (TNF)-α, insulin-like growth factor (IGF)-1, fibroblast growth factor (FGF)-2, transforming growth factor (TGF)-β1, IL-1β, and interleukin-1 receptor antagonist (IL-1ra). Serum, in addition to plasma and ACS, was collected from an additional 6 dogs for TNF-α, IL-1β, and IL-1ra analysis (total of 22 dogs). Data were analyzed for differences in each cytokine concentration using pairwise comparisons between ACS, plasma, and serum using Wilcoxon signed-rank tests. Significance was set at P<.05. RESULTS There was a large variability in growth factor and cytokine concentrations in ACS and plasma for individual dogs. There were no significant differences in IL-10, TNF-α, IGF-1, FGF-2, and TGF-β1 concentrations between ACS, plasma, and serum. The IL-1β concentrations in ACS (median, range 46.3 pg/mL, 0-828.8) and IL-4 (0.0 pg/mL, 0-244.1) were significantly higher than plasma (36.6 pg/mL, 0-657.1 and 0.0 pg/mL, 0-0, respectively). The IL-1ra concentration in ACS (median, range 3,458.9 pg/mL, 1,243.1-12,089.0) was significantly higher than plasma (692.3 pg/mL, 422.5-1,475.6). The IL-1ra:IL-1β ratio in ACS was significantly higher than plasma (39.9 vs. 7.2). CONCLUSION IL-1ra concentrations in canine ACS were comparable to those published for people and horses and pro-inflammatory cytokines remained low in canine ACS.
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Affiliation(s)
- Dominique M Sawyere
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
| | - Otto I Lanz
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
| | - Linda A Dahlgren
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
| | - Sabrina L Barry
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
| | - Anne C Nichols
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
| | - Stephen R Werre
- Laboratory for Study Design and Statistical Analysis, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia
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18
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Borer L, Seewald W, Peel J, King J. Evaluation of the dose-response relationship of oral robenacoxib in urate crystal-induced acute stifle synovitis in dogs. J Vet Pharmacol Ther 2016; 40:148-157. [DOI: 10.1111/jvp.12348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
- L.R. Borer
- Elanco Animal Health Research Centre; St-Aubin Switzerland
| | - W. Seewald
- Elanco Animal Health Inc.; Basel Switzerland
| | - J.E. Peel
- Elanco Animal Health Research Centre; St-Aubin Switzerland
| | - J.N. King
- Elanco Animal Health Inc.; Basel Switzerland
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19
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Panteri A, Kukk A, Desevaux C, Seewald W, King JN. Effect of benazepril and robenacoxib and their combination on glomerular filtration rate in dogs. J Vet Pharmacol Ther 2016; 40:44-56. [PMID: 27302598 DOI: 10.1111/jvp.12325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
Combined use of angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs may induce acute kidney injury, especially when combined with diuretics. The objective of this investigation was to evaluate the effect of benazepril, robenacoxib and their combination in healthy dogs. In each of two studies (studies 1 and 2), 32 beagle dogs were randomized into one of four groups in a parallel-group design. Groups received once-daily oral treatment for 7 days with placebo, benazepril, robenacoxib or benazepril plus robenacoxib. In study 2, all dogs received additionally 2 mg/kg furosemide orally twice daily. The primary endpoint was the glomerular filtration rate (GFR) estimated from the plasma clearance of iohexol. Secondary endpoints included standard clinical monitoring and, in study 2, plasma renin activity, urine volume, specific gravity and aldosterone concentration and water intake. Administration of furosemide induced diuresis, reduced GFR and activated the renin-aldosterone-angiotensin system. Benazepril and robenacoxib, administered alone or in combination, were tolerated well, did not decrease GFR with or without co-administration of furosemide and significantly reduced urinary aldosterone concentrations. No increased risk of acute kidney injury was identified with the combination of benazepril and robenacoxib in healthy dogs. Different effects might occur in dogs with heart or renal disease.
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Affiliation(s)
- A Panteri
- Preclinical, Elanco Centre de Recherche Santé Animale, St-Aubin, Switzerland
| | - A Kukk
- Preclinical, Elanco Centre de Recherche Santé Animale, St-Aubin, Switzerland
| | - C Desevaux
- Safety, Elanco Animal Health, Basel, Switzerland
| | - W Seewald
- Companion Animal Development, Elanco Animal Health, Basel, Switzerland
| | - J N King
- Companion Animal Development, Elanco Animal Health, Basel, Switzerland
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20
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Hunt JR, Dean RS, Davis GND, Murrell JC. An analysis of the relative frequencies of reported adverse events associated with NSAID administration in dogs and cats in the United Kingdom. Vet J 2015; 206:183-90. [PMID: 26361747 DOI: 10.1016/j.tvjl.2015.07.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 12/14/2022]
Abstract
This study aimed to analyse UK pharmacovigilance data to quantify adverse events (AEs) associated with the non-steroidal anti-inflammatory drug (NSAID) molecules found in veterinary medicines authorised for use in dogs and cats. It was hypothesised that the frequency of AEs would be lower when associated with cyclo-oxygenase-2 selective (coxib), compared to non-selective (non-coxib) NSAIDs. The UK Veterinary Medicines Directorate (VMD) supplied frequencies of AEs derived from Periodic Safety Update Reports subdivided by formulation and species for each NSAID molecule. Frequencies of AEs were similar between species. The five most reported AEs were emesis, death, anorexia, lethargy, and diarrhoea. Reported frequency of emesis, renal insufficiency and death was higher with injectable compared to oral NSAIDs (P = 0.043). Reported frequency of emesis, lethargy and death was higher with coxib, compared to non-coxib NSAIDs (P = 0.029). Median (range) interval since authorisation was shorter for coxibs at 5 (2.5-9) years compared to non-coxibs at 15 (12-25) years. A negative correlation between time elapsed since authorisation and the frequency of AEs was identified (rs = -0.11 to -0.94). Higher frequency of reported AEs with injectable NSAIDs may be related to perioperative administration. The AE frequency associated with coxib and non-coxib NSAIDs may be confounded by changes in reporting habits over time. This study highlights the value of interrogating passive surveillance data to identify low frequency AEs and the need to facilitate improvement in recording and collecting AEs in small animal practice.
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Affiliation(s)
- James R Hunt
- University of Bristol, School of Veterinary Sciences, Langford BS40 5DU, UK.
| | - Rachel S Dean
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK
| | - Giles N D Davis
- Pharmacovigilance Unit, Veterinary Medicines Directorate, Woodham Lane, New Haw, Addlestone, Surrey KT15 3LS, UK
| | - Joanna C Murrell
- University of Bristol, School of Veterinary Sciences, Langford BS40 5DU, UK
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21
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Kim TW, Della Rocca G, Di Salvo A, Ryschanova R, Sgorbini M, Giorgi M. Evaluation of pharmacokinetic and pharmacodynamic properties of cimicoxib in fasted and fed horses. N Z Vet J 2015; 63:92-7. [DOI: 10.1080/00480169.2014.950355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Laffont CM, Vandemeulebroecke M, Concordet D. Multivariate Analysis of Longitudinal Ordinal Data With Mixed Effects Models, With Application to Clinical Outcomes in Osteoarthritis. J Am Stat Assoc 2014. [DOI: 10.1080/01621459.2014.917977] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Kim TW, Vercelli C, Briganti A, Re G, Giorgi M. The pharmacokinetics and in vitro/ex vivo cyclooxygenase selectivity of parecoxib and its active metabolite valdecoxib in cats. Vet J 2014; 202:37-42. [PMID: 25135338 DOI: 10.1016/j.tvjl.2014.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 07/26/2014] [Accepted: 07/28/2014] [Indexed: 10/25/2022]
Abstract
Parecoxib (PX) is an injectable prodrug of valdecoxib (VX, which is a selective cyclo-oxyganase-2 (COX-2)) inhibitor licensed for humans. The aim of the present study was to evaluate pharmacokinetics and in vitro/ex vivo cyclooxygenase selectivity of PX and VX in cats. In a whole blood in vitro study, PX did not affect either COX enzymes whereas VX revealed a COX-2 selective inhibitory effect in feline whole blood. The IC50 values of VX for COX-2 and COX-1 were 0.45 and 38.6 µM, respectively. Six male cats were treated with 2.5 mg/kg of PX by intramuscular injection. PX was rapidly converted to VX with a relatively short half-life of 0.4 h. VX achieved peak plasma concentration (2.79 ± 1.59 µg/mL) at 7 h following PX injection. The mean residence times for PX and VX were 0.43 ± 0.15 and 5.94 ± 0.88 h, respectively. In the ex vivo study, PX showed a COX-2 inhibition rate of about 70% in samples taken at 1, 2, 4 and 10 h after injection, with a significant difference compared to the control. In contrast, COX-1 was slightly inhibited, ranging from 0.7% to 9.7% of the control inhibition rate without any significant difference for 24 h after PX administration. The preliminary findings of the present research appear promising and encourage further studies to investigate whether PX can be successfully used in feline medicine.
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Affiliation(s)
- T W Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - C Vercelli
- Department of Veterinary Sciences, Division of Pharmacology & Toxicology, University of Turin, Via L. da Vinci 44, 10095 Grugliasco, Torino, Italy
| | - A Briganti
- Department of Veterinary Sciences, University of Pisa, Via Livornese (lato monte) 1, 56122 San Piero a Grado, Pisa, Italy
| | - G Re
- Department of Veterinary Sciences, Division of Pharmacology & Toxicology, University of Turin, Via L. da Vinci 44, 10095 Grugliasco, Torino, Italy
| | - M Giorgi
- Department of Veterinary Sciences, University of Pisa, Via Livornese (lato monte) 1, 56122 San Piero a Grado, Pisa, Italy.
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24
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Kim T, Łebkowska-Wieruszewska B, Owen H, Yun H, Kowalski C, Giorgi M. Pharmacokinetic profiles of the novel COX-2 selective inhibitor cimicoxib in dogs. Vet J 2014; 200:77-81. [DOI: 10.1016/j.tvjl.2013.12.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 12/17/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
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25
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Murrell J, Grandemange E, Woehrle F, Menard J, White K. Clinical Efficacy and Tolerability of Cimicoxib in Dogs with Osteoarthritis: A Multicentre Prospective Study. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojvm.2014.45010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Freise KJ, Lin TL, Fan TM, Recta V, Clark TP. Evidence-based medicine: the design and interpretation of noninferiority clinical trials in veterinary medicine. J Vet Intern Med 2013; 27:1305-17. [PMID: 24128266 DOI: 10.1111/jvim.12211] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 08/08/2013] [Accepted: 08/27/2013] [Indexed: 11/28/2022] Open
Abstract
Noninferiority trials are clinical studies designed to demonstrate that an investigational drug is at least as effective as an established treatment within a predetermined margin. They are conducted, in part, because of ethical concerns of administering a placebo to veterinary patients when an established effective treatment exists. The use of noninferiority trial designs has become more common in veterinary medicine with the increasing number of established veterinary therapeutics and the desire to eliminate potential pain or distress in a placebo-controlled study. Selecting the appropriate active control and an a priori noninferiority margin between the investigational and active control drug are unique and critical design factors for noninferiority studies. Without reliable historical knowledge of the disease response in the absence of treatment and of the response to the selected active control drug, proper design and interpretation of a noninferiority trial is not possible. Despite the appeal of conducting noninferiority trials to eliminate ethical concerns of placebo-controlled studies, there are real limitations and possible ethical conundrums associated with noninferiority trials. The consequences of incorrect study conclusions because of poor noninferiority trial design need careful attention. Alternative trial designs to typical noninferiority studies exist, but these too have limitations and must also be carefully considered.
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Affiliation(s)
- K J Freise
- Nexcyon Pharmaceuticals Inc, Madison, WI
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27
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Population pharmacokinetic analysis of blood concentrations of robenacoxib in dogs with osteoarthritis. Res Vet Sci 2013; 95:580-7. [DOI: 10.1016/j.rvsc.2013.04.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/04/2013] [Accepted: 04/20/2013] [Indexed: 11/21/2022]
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28
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Monteiro-Steagall BP, Steagall PVM, Lascelles BDX. Systematic review of nonsteroidal anti-inflammatory drug-induced adverse effects in dogs. J Vet Intern Med 2013; 27:1011-9. [PMID: 23782347 DOI: 10.1111/jvim.12127] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/08/2013] [Accepted: 05/14/2013] [Indexed: 12/01/2022] Open
Abstract
The aim of this systematic review was to identify, assess, and critically evaluate the quality of evidence of nonsteroidal anti-inflammatory drug (NSAID)-induced adverse effects in dogs. Original prospective studies published in peer-reviewed journals in English (1990-2012) that reported data on the safety of NSAIDs administration in dogs were searched. For each study, design type (I, II, III, or IV) and assessment of quality (+, Ø, -) were rated. For each drug, quantity and consistency rating (***, **, *) and strength of evidence (high, moderate, low, or extremely low) were identified and evaluated. The strength of evidence was defined in terms of how applicable and relevant the conclusions were to the target population. Sixty-four studies met the inclusion criteria. Thirty-five (55%) research studies and 29 (45%) clinical trials were identified. A high strength of evidence existed for carprofen, firocoxib, and meloxicam; moderate for deracoxib, ketoprofen, and robenacoxib; and low for etodolac. Quality and consistency rating were as follows: carprofen (***/***), deracoxib (**/***), etodolac (*/unable to rate), firocoxib (***/**), ketoprofen (**/***), meloxicam (***/***), and robenacoxib (**/**), respectively. Adverse effects were detected in 35 studies (55%) and commonly included vomiting, diarrhea, and anorexia. Three studies (5%) reported a power analysis related to adverse effects of ≥80%. In randomized, placebo-controlled, blinded studies (n = 25, 39%), the incidence of adverse effects was not statistically different between treated and control dogs. Finally, most studies were not appropriately designed to determine the safety of NSAIDs, and involved a healthy nongeriatric population of research dogs.
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Affiliation(s)
- B P Monteiro-Steagall
- Veterinary Anesthesia Consultancy Services, Rua Cel. Mello de Oliveira, Sao Paulo, Brazil
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29
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Silber HE, Burgener C, Letellier IM, Peyrou M, Jung M, King JN, Gruet P, Giraudel JM. Population pharmacokinetic analysis of blood and joint synovial fluid concentrations of robenacoxib from healthy dogs and dogs with osteoarthritis. Pharm Res 2010; 27:2633-45. [PMID: 20922466 DOI: 10.1007/s11095-010-0262-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 08/26/2010] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of this population analysis was to characterize the pharmacokinetic properties of robenacoxib in blood and stifle joint synovial fluid of dogs. METHODS Data were obtained from two studies: 1) 8 healthy Beagle dogs in which an acute inflammation was induced by injection of urate crystals into one joint; 2) 95 dogs from various breeds diagnosed with osteoarthritis (OA). Robenacoxib concentrations in blood and synovial fluid were measured using a validated HPLC-UV and LC-MS method. Non-linear mixed effects modeling was performed using NONMEM6. RESULTS A two-compartment pharmacokinetic model with linear elimination was developed to describe blood concentrations of robenacoxib. Blood clearance in healthy animals was found to be 75% higher than in OA dogs. Synovial fluid concentrations were modeled using an effect-compartment-type model predicting longer residence times in OA dogs compared to healthy Beagles (e.g. concentrations above the IC(50) for COX-2, respectively, 16 h vs. 10 h at 1.5 mg/kg). CONCLUSIONS Robenacoxib was found to reside longer at the effect site (inflamed joint) compared to blood in both healthy and OA dogs. These results may explain the good efficacy observed with once-daily dosing in clinical trials and the high safety index of robenacoxib in dogs.
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Affiliation(s)
- Hanna E Silber
- Novartis Pharma AG, Modeling & Simulation Pharmacology, Postfach, Basel, Switzerland.
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