BMC Veterinary Research | |
Assessment into the usage of levetiracetam in a canine epilepsy clinic | |
Holger A Volk1  Sian Elizabeth Porter1  George Nye1  Rowena MA Packer1  | |
[1] Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL97TA, UK | |
关键词: Treatment; Tolerability; Seizure; Safety; Dog; | |
Others : 1131412 DOI : 10.1186/s12917-015-0340-x |
|
received in 2014-09-11, accepted in 2015-01-22, 发布年份 2015 | |
【 摘 要 】
Background
Retrospective studies can complement information derived from double-blinded randomized trials. There are multiple retrospective studies reporting good efficacy and tolerability of the anti-epileptic drug levetiracetam (LEV) in human patients with epilepsy; however, reports of LEV's tolerability and efficacy in dogs with epilepsy remain limited. The purpose of this retrospective study was to describe the use of LEV in a canine epilepsy clinic and determine the long-term efficacy and tolerability of LEV in veterinary clinical practice. The electronic database of a UK based referral hospital was searched for LEV usage in dogs with seizures. Information and data necessary for the evaluation were obtained from a combination of electronic and written hospital records, the referring veterinary surgeons’ records and telephone interviews with dog owners. Only dogs that were reportedly diagnosed with idiopathic epilepsy were included in the study.
Results
Fifty-two dogs were included in this retrospective study. Two treatment protocols were recognised; 29 dogs were treated continuously with LEV and 23 dogs received interval or pulse treatment for cluster seizures. LEV treatment resulted in 69% of dogs having a 50% or greater reduction of seizure frequency whilst 15% of all the dogs were completely free from seizures. Seizure frequency reduced significantly in the whole population. No dog was reported to experience life-threatening side effects. Mild side effects were experienced by 46% of dogs and a significantly higher number of these dogs were in the pulse treatment group. The most common side-effects reported were sedation and ataxia.
Conclusions
LEV appears to be effective and well tolerated for reduction of seizures.
【 授权许可】
2015 Packer et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150302050149398.pdf | 482KB | download | |
Figure 1. | 31KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Betts T, Yarrow H, Greenhill L, Barrett M: Clinical experience of marketed Levetiracetam in an epilepsy clinic-a one year follow up study. Seizure 2003, 12(3):136-140.
- [2]Mohanraj R, Brodie MJ: Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 2006, 13(3):277-282.
- [3]Beghi E: Efficacy and tolerability of the new antiepileptic drugs: comparison of two recent guidelines. Lancet Neurol 2004, 3(10):618-621.
- [4]French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, et al.: Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2004, 62(8):1261-1273.
- [5]French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, et al.: Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2004, 62(8):1252-1260.
- [6]Kuba R, Novotna I, Brazdil M, Kocvarova J, Tyrlikova I, Mastik J, et al.: Long-term levetiracetam treatment of epilepsy patients: clinical audit. Epilepsy Res 2006, 72(2–3):111-119.
- [7]Kuba R, Novotna I, Brazdil M, Kocvarova J, Tyrlikova I, Mastik J, et al.: Long-term levetiracetam treatment in patients with epilepsy: 3-year follow up. Acta Neurol Scand 2010, 121(2):83-88.
- [8]Stephen LJ, Kelly K, Parker P, Brodie MJ: Levetiracetam monotherapy–outcomes from an epilepsy clinic. Seizure 2011, 20(7):554-557.
- [9]Dewey CW, Cerda-Gonzalez S, Levine JM, Badgley BL, Ducoté JM, Silver GM, et al.: Pregabalin as an adjunct to phenobarbital, potassium bromide, or a combination of phenobarbital and potassium bromide for treatment of dogs with suspected idiopathic epilepsy. J Am Vet Med Assoc 2009, 235(12):1442-1449.
- [10]Dewey CW, Guiliano R, Boothe DM, Berg JM, Kortz GD, Joseph RJ, et al.: Zonisamide therapy for refractory idiopathic epilepsy in dogs. J Am Anim Hosp Assoc 2004, 40(4):285-291.
- [11]Govendir M, Perkins M, Malik R: Improving seizure control in dogs with refractory epilepsy using gabapentin as an adjunctive agent. Aust Vet J 2005, 83(10):602-608.
- [12]Muñana KR, Thomas WB, Inzana KD, Nettifee-Osborne JA, McLucas KJ, Olby NJ, et al.: Evaluation of levetiracetam as adjunctive treatment for refractory canine epilepsy: a randomized, placebo-controlled, crossover trial. J Vet Intern Med 2012, 26(2):341-348.
- [13]Platt SR, Adams V, Garosi LS, Abramson CJ, Penderis J, De Stefani A, et al.: Treatment with gabapentin of 11 dogs with refractory idiopathic epilepsy. Vet Rec 2006, 159(26):881-884.
- [14]Volk HA, Matiasek LA, Luján Feliu-Pascual A, Platt SR, Chandler KE: The efficacy and tolerability of levetiracetam in pharmacoresistant epileptic dogs. Vet J 2008, 176(3):310-319.
- [15]von Klopmann T, Rambeck B, Tipold A: Prospective study of zonisamide therapy for refractory idiopathic epilepsy in dogs. J Small Anim Pract 2007, 48(3):134-138.
- [16]Gillard M, Chatelain P, Fuks B: Binding characteristics of levetiracetam to synaptic vesicle protein 2A (SV2A) in human brain and in CHO cells expressing the human recombinant protein. Eur J Pharmacol 2006, 536(1–2):102-108.
- [17]Lynch BA, Lambeng N, Nocka K, Kensel-Hammes P, Bajjalieh SM, Matagne A, et al.: The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci U S A 2004, 101(26):9861-9866.
- [18]Klitgaard H, Pitkanen A: Antiepileptogenesis, neuroprotection, and disease modification in the treatment of epilepsy: focus on levetiracetam. Epileptic Disord 2003, 5:S9-S16.
- [19]Löscher W, Honack D, Rundfeldt C: Antiepileptogenic effects of the novel anticonvulsant levetiracetam (ucb L059) in the kindling model of temporal lobe epilepsy. J Pharmacol Exp Ther 1998, 284(2):474-479.
- [20]Ohno Y, Ishihara S, Terada R, Serikawa T, Sasa M: Antiepileptogenic and anticonvulsive actions of levetiracetam in a pentylenetetrazole kindling model. Epilepsy Res 2010, 89(2–3):360-364.
- [21]Yan HD, Cai JQ, Ishihara K, Nagayama T, Serikawa T, Sasa M: Separation of antiepileptogenic and antiseizure effects of levetiracetam in the spontaneously epileptic rat (SER). Epilepsia 2005, 46(8):1170-1177.
- [22]Fryer KJ, Levine JM, Peycke LE, Thompson JA, Cohen ND: Incidence of postoperative seizures with and without levetiracetam pretreatment in dogs undergoing portosystemic shunt attenuation. J Vet Intern Med 2011, 25(6):1379-1384.
- [23]Hardy BT, Patterson EE, Cloyd JM, Hardy RM, Leppik IE: Double-masked, placebo-controlled study of intravenous levetiracetam for the treatment of status epilepticus and acute repetitive seizures in dogs. J Vet Intern Med 2012, 26(2):334-340.
- [24]Steinberg M, Faissler D: Levetiracetam therapy for longterm idiopathic epileptic dogs. J Vet Intern Med 2004, 18(3):410.
- [25]Kwan P, Brodie MJ: Early identification of refractory epilepsy. N Engl J Med 2000, 342(5):314-319.
- [26]Berendt M, Gram L: Epilepsy and seizure classification in 63 dogs: a reappraisal of veterinary epilepsy terminology. J Vet Intern Med 1999, 13(1):14-20.
- [27]Licht BG, Licht MH, Harper KM, Lin S, Curtin JJ, Hyson LL, et al.: Clinical presentations of naturally occurring canine seizures: similarities to human seizures. Epilepsy Behav 2002, 3(5):460-470.
- [28]Arrol L, Penderis J, Garosi L, Cripps P, Gutierrez-Quintana R, Goncalves R: Aetiology and long-term outcome of juvenile epilepsy in 136 dogs. Vet Rec 2012, 170(13):335.
- [29]Berendt M, Gredal H, Ersbøll AK, Alving J: Premature death, risk factors, and life patterns in dogs with epilepsy. J Vet Intern Med 2007, 21(4):754-759.
- [30]Heynold Y, Faissler D, Steffen F, Jaggy A: Clinical, epidemiological and treatment results of idiopathic epilepsy in 54 labrador retrievers: a long-term study. J Small Anim Pract 1997, 38(1):7-14.
- [31]Packer RM, Shihab NK, Torres BB, Volk HA: Clinical risk factors associated with anti-epileptic drug responsiveness in canine epilepsy. PLoS One 2014, 9(8):e106026.
- [32]Brodie MJ, Perucca E, Ryvlin P, Ben-Menachem E, Meencke HJ: Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. Neurology 2007, 68(6):402-408.
- [33]Short AD, Dunne A, Lohi H, Boulton S, Carter SD, Timofte D, et al.: Characteristics of epileptic episodes in UK dog breeds: an epidemiological approach. Vet Rec 2011, 169(2):48.
- [34]French J, di Nicola S, Arrigo C: Fast and sustained efficacy of levetiracetam during titration and the first 3 months of treatment in refractory epilepsy. Epilepsia 2005, 46(8):1304-1307.
- [35]Löscher W, Schmidt D: Experimental and clinical evidence for loss of effect (tolerance) during prolonged treatment with antiepileptic drugs. Epilepsia 2006, 47(8):1253-1284.
- [36]Moore SA, Muñana KR, Papich MG, Nettifee-Osborne JA: The pharmacokinetics of levetiracetam in healthy dogs concurrently receiving phenobarbital. J Vet Pharmacol Ther 2011, 34(1):31-34.
- [37]Muñana KR, Zhang D, Patterson EE: Placebo effect in canine epilepsy trials. J Vet Intern Med 2010, 24(1):166-170.
- [38]Dewey CW: Anticonvulsant therapy in dogs and cats. Vet Clin North Am Small Anim Pract 2006, 36(5):1107-1127. vii
- [39]Briggs DE, French JA: Levetiracetam safety profiles and tolerability in epilepsy patients. Expert Opin Drug Saf 2004, 3(5):415-424.
- [40]Harden C: Safety profile of levetiracetam. Epilepsia 2001, 42(Suppl 4):36-39.
- [41]Shihab N, Bowen J, Volk HA: Behavioral changes in dogs associated with the development of idiopathic epilepsy. Epilepsy Behav 2011, 21(2):160-167.
- [42]Löscher W, Brandt C: High seizure frequency prior to antiepileptic treatment is a predictor of pharmacoresistant epilepsy in a rat model of temporal lobe epilepsy. Epilepsia 2010, 51(1):89-97.
- [43]Regesta G, Tanganelli P: Clinical aspects and biological bases of drug-resistant epilepsies. Epilepsy Res 1999, 34(2–3):109-122.