Open-label clinical trial of rectally administered levetiracetam as supplemental treatment in dogs with cluster seizures.
Administration, Intravenous
/ veterinary
Administration, Rectal
Animals
Anticonvulsants
/ administration & dosage
Diazepam
/ administration & dosage
Dog Diseases
/ drug therapy
Dogs
Levetiracetam
/ administration & dosage
Male
Phenobarbital
/ administration & dosage
Seizures
/ drug therapy
Status Epilepticus
/ drug therapy
dogs
epilepsy
neurology
therapy
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
15
01
2019
accepted:
17
05
2019
pubmed:
21
6
2019
medline:
4
12
2019
entrez:
21
6
2019
Statut:
ppublish
Résumé
Treatment options for at-home management of cluster seizures (CS) and status epilepticus (SE) are limited. The pharmacokinetics of levetiracetam (LEV) after rectal administration in both healthy and epileptic dogs has been investigated recently. To investigate the clinical efficacy of rectally administered LEV in preventing additional seizures in dogs presented for CS and SE. We hypothesized that rectal administration of LEV in addition to a standard treatment protocol would provide better control of seizure activity as compared with the standard treatment protocol alone. Fifty-seven client-owned dogs with CS or SE. Prospective open-label clinical trial. Patients included in the study were assigned to receive either a standard treatment protocol comprising IV/rectal diazepam and IV phenobarbital q8h (control group) or a standard treatment protocol in association with a single dose of 40 mg/kg LEV rectally (rectal LEV group). Dogs that experienced no additional seizures were defined as responders, whereas those that showed additional seizure activity were classified as nonresponders. Twenty-one dogs were assigned to the rectal LEV group, and 36 to control group. Given the small number of cases of SE, statistical analysis was performed only on patients with CS. The response rate was 94% in the rectal LEV group and 48% in the control group (P < .001). Rectally administered LEV combined with a standard treatment protocol provided good control of seizure activity in patients with CS. The validity of these results should be confirmed in a double-blinded, placebo-controlled clinical trial.
Sections du résumé
BACKGROUND
BACKGROUND
Treatment options for at-home management of cluster seizures (CS) and status epilepticus (SE) are limited. The pharmacokinetics of levetiracetam (LEV) after rectal administration in both healthy and epileptic dogs has been investigated recently.
HYPOTHESIS/OBJECTIVES
OBJECTIVE
To investigate the clinical efficacy of rectally administered LEV in preventing additional seizures in dogs presented for CS and SE. We hypothesized that rectal administration of LEV in addition to a standard treatment protocol would provide better control of seizure activity as compared with the standard treatment protocol alone.
ANIMALS
METHODS
Fifty-seven client-owned dogs with CS or SE.
METHODS
METHODS
Prospective open-label clinical trial. Patients included in the study were assigned to receive either a standard treatment protocol comprising IV/rectal diazepam and IV phenobarbital q8h (control group) or a standard treatment protocol in association with a single dose of 40 mg/kg LEV rectally (rectal LEV group). Dogs that experienced no additional seizures were defined as responders, whereas those that showed additional seizure activity were classified as nonresponders.
RESULTS
RESULTS
Twenty-one dogs were assigned to the rectal LEV group, and 36 to control group. Given the small number of cases of SE, statistical analysis was performed only on patients with CS. The response rate was 94% in the rectal LEV group and 48% in the control group (P < .001).
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Rectally administered LEV combined with a standard treatment protocol provided good control of seizure activity in patients with CS. The validity of these results should be confirmed in a double-blinded, placebo-controlled clinical trial.
Identifiants
pubmed: 31218767
doi: 10.1111/jvim.15541
pmc: PMC6639497
doi:
Substances chimiques
Anticonvulsants
0
Levetiracetam
44YRR34555
Diazepam
Q3JTX2Q7TU
Phenobarbital
YQE403BP4D
Types de publication
Clinical Trial, Veterinary
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1714-1718Subventions
Organisme : Ministero dell'Istruzione, dell'Università e della Ricerca
Informations de copyright
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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