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Lack of evidence of a beneficial effect of azathioprine in dogs treated with prednisolone for idiopathic immune-mediated hemolytic anemia: a retrospective cohort study.
- Source :
-
BMC veterinary research [BMC Vet Res] 2011 Apr 13; Vol. 7, pp. 15. Date of Electronic Publication: 2011 Apr 13. - Publication Year :
- 2011
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Abstract
- Background: Azathioprine is used as an immunosuppressant in canine immune-mediated hemolytic anemia (IMHA), but this potentially toxic and carcinogenic drug has not been proven to be beneficial. The aim of this study was to determine the difference in outcome and survival of dogs with idiopathic IMHA treated with a protocol that included azathioprine and prednisolone versus a protocol that included prednisolone alone.<br />Results: The study included 222 dogs with a hematocrit lower than 0.30 L/L and either a positive Coombs' test or spherocytosis and no evidence of diseases that could trigger IMHA. The clinical and laboratory data at the time of diagnosis and the response to therapy and survival were compared in dogs treated according to the prednisolone and azathioprine protocol (AP protocol; n = 149) and dogs treated according to the prednisolone protocol (P protocol; n = 73). At study entry, the two groups were comparable, except that thrombocyte counts were significantly lower and clinical signs had been present significantly longer in the AP protocol group. No significant difference in survival was found between the two groups: the 1-year survival was 64% (95% CI 54 - 77%) in the P protocol group and 69% (95% CI 59-80%) in the AP protocol group, respectively.<br />Conclusions: Azathioprine would appear not to be beneficial as standard treatment for all cases of IMHA; however, a blinded, randomized clinical trial is needed to establish whether outcome is different with the two treatment protocols.
- Subjects :
- Anemia, Hemolytic, Autoimmune blood
Anemia, Hemolytic, Autoimmune drug therapy
Anemia, Hemolytic, Autoimmune immunology
Animals
Blood Platelets drug effects
Blood Platelets metabolism
Cohort Studies
Dog Diseases blood
Dog Diseases immunology
Dogs
Drug Therapy, Combination veterinary
Female
Fibrinogen metabolism
Kaplan-Meier Estimate
Male
Partial Thromboplastin Time veterinary
Prothrombin Time veterinary
Retrospective Studies
Anemia, Hemolytic, Autoimmune veterinary
Azathioprine therapeutic use
Dog Diseases drug therapy
Immunosuppressive Agents therapeutic use
Prednisolone therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1746-6148
- Volume :
- 7
- Database :
- MEDLINE
- Journal :
- BMC veterinary research
- Publication Type :
- Academic Journal
- Accession number :
- 21489250
- Full Text :
- https://doi.org/10.1186/1746-6148-7-15