Comparison of platelet count recovery with use of vincristine and prednisone or prednisone alone for treatment for severe immune-mediated thrombocytopenia in dogs

Abstract

Administration of combined vincristine and prednisone is associated with more rapid increase in platelet numbers and shortened duration of hospitalization in dogs with IMT, compared with use of prednisone alone. Early use of vincristine seems warranted in dogs with severe primary IMT.

A Prospective Randomized Clinical Trial of Vincristine versus Human Intravenous Immunoglobulin for Acute Adjunctive Management of Presumptive Primary Immune‐Mediated Thrombocytopenia in Dogs

“…The median platelet recovery time of 2.5 days for both groups in this study was similar to the recovery times reported in the treatment arms of both previous prospective studies evaluating VINC and hIVIG for treatment of presumptive ITP. 7,8 In a study evaluating hIVIG treatment of dogs with ITP, the median recovery time for dogs treated with hIVIG was 3.5 days 8 and in a study evaluating VINC as an adjunctive treatment for ITP, the median recovery time for dogs treated with VINC was 4.5 days. 7 The recovery times for both groups in this study were shorter than the glucocorticoid only arms of these previous prospective clinical trials, which were 7.5 days and 6.5 days for hIVIG and VINC, respectively.…”

“…7,8 In a study evaluating hIVIG treatment of dogs with ITP, the median recovery time for dogs treated with hIVIG was 3.5 days 8 and in a study evaluating VINC as an adjunctive treatment for ITP, the median recovery time for dogs treated with VINC was 4.5 days. 7 The recovery times for both groups in this study were shorter than the glucocorticoid only arms of these previous prospective clinical trials, which were 7.5 days and 6.5 days for hIVIG and VINC, respectively. The median duration of hospitalization of 4 days for the dogs in this study also was similar to that reported in the previous studies of hIVIG (4 days) and VINC (5 days).…”

“…Most patients exhibit platelet count recovery within 1-15 days after initiating treatment with glucocorticoids, 3,4 but adjunctive treatment with VINC and hIVIG have been demonstrated to shorten platelet recovery time. 7,8 In a prospective study assessing platelet recovery time in dogs with severe ITP treated with prednisone alone versus prednisone and VINC, administration of VINC and prednisone together was associated with a more rapid increase in platelet numbers and shortened duration of hospitalization in dogs with ITP, compared with use of prednisone. 7 In a prospective study assessing the adjunctive effects of hIVIG versus placebo in dogs with ITP, dogs treated with hIVIG and prednisone had a reduction in platelet recovery time and length of hospitalization compared with those treated with prednisone and placebo.…”

“…7,8 In a prospective study assessing platelet recovery time in dogs with severe ITP treated with prednisone alone versus prednisone and VINC, administration of VINC and prednisone together was associated with a more rapid increase in platelet numbers and shortened duration of hospitalization in dogs with ITP, compared with use of prednisone. 7 In a prospective study assessing the adjunctive effects of hIVIG versus placebo in dogs with ITP, dogs treated with hIVIG and prednisone had a reduction in platelet recovery time and length of hospitalization compared with those treated with prednisone and placebo. 8 Efficacy of other drugs for adjunctive treatment of acute ITP has not been studied and there are no published studies comparing the efficacy of VINC versus hIVIG.…”

Canine idiopathic immune-mediated haemolytic anaemia: a review with recommendations for future research

“…However, antiplatelet antibody testing is not routinely available in veterinary practice. The thrombocyte count cut-off to distinguish between ITP and disseminated intravascular coagulation (DIC) in dogs has been reported as 15 Â 10 9 /L (Rozanski et al 2002), although another study reported median thrombocyte counts of 32 Â 10 9 /L in dogs with ITP and 55 Â 10 9 /L in dogs with DIC (Botsch et al 2009). …”