Treatment of canine idiopathic immune-mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)
Treatment of canine idiopathic immune-mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)
复制标题
DOI：
10.1111/jsap.12107
复制
发表时间：
2013-08-01
影响因子：
1.6
通讯作者：
Creevy, K. E.
中科院分区：
文献类型：
--
作者：
Wang, A.;Smith, J. R.;Creevy, K. E.
目的比较糖皮质激素和霉酚酸酯与其他免疫抑制方案治疗特发性免疫介导的溶血性贫血犬的短期疗效和不良事件发生率。收集的数据包括显著性、临床病理学数据、给药情况、住院时间、短期生存率和不良事件。结果64例特发性免疫介导的溶血性贫血患者中，有1例为糖皮质激素联合吗替麦考酚酯治疗组，另1例为联合用药组。两只狗在没有治疗的情况下被安乐死，三只接受糖皮质激素单独治疗，七只接受两种额外的药物治疗。52只狗接受糖皮质激素和其他免疫抑制药物：30霉酚酸酯，15环孢素，6硫唑嘌呤和1人免疫球蛋白。霉酚酸酯组与联合组的出院率、30天或60天生存率无显著差异（Fisher精确检验，P=0272、0518、1000）。在霉酚酸酯组中观察到的唯一不良事件是腹泻（n=5）。临床意义霉酚酸酯给药在患有特发性免疫介导的溶血性贫血的狗中似乎是安全的。糖皮质激素和吗替麦考酚酯的组合与用于治疗这种疾病的替代免疫抑制方案具有相似的疗效。
Objective To compare short-term outcome and frequency of adverse events for dogs with idiopathic immune-mediated haemolytic anaemia treated with glucocorticoids and mycophenolate mofetil vs alternate immunosuppressive protocols.Methods A retrospective study of medical case records of dogs with immune-mediated haemolytic anaemia was conducted. Data collected included signalment, clinicopathological data, medications administered, duration of hospitalization, short-term survival and adverse events. Variables were compared between dogs treated with glucocorticoids and mycophenolate mofetil (mycophenolate mofetil group) vs dogs treated with other two-drug immunosuppressive protocols (combined group).Results Sixty-four cases of idiopathic immune-mediated haemolytic anaemia were identified. Two dogs were euthanased without treatment, three received glucocorticoids alone, and seven received two additional drugs. Fifty-two dogs received glucocorticoids and additional immunosuppressive medications: 30 mycophenolate mofetil, 15 cyclosporine, 6 azathioprine and 1 human immunoglobulin. There was no significant difference between the discharge rate, 30-day or 60-day survival rates between the mycophenolate mofetil and the combined groups (Fisher's exact; P=0272, 0518, 1000, respectively). The sole adverse event observed in the mycophenolate mofetil group was diarrhoea (n=5).Clinical Significance Administration of mycophenolate mofetil appears safe in dogs with idiopathic immune-mediated haemolytic anaemia. The combination of glucocorticoids and mycophenolate mofetil has similar efficacy to alternate immunosuppressive protocols used to treat this disease.