Efficacy of afoxolaner plus milbemycin oxime chewable tablets against naturally acquired intestinal nematodes in dogs

Rehbein, Steffen; Dorr, Paul M.; Bowman, Dwight D.; Crafford, Dionne; Kusi, Ilir; Postoli, Rezart; Yoon, Stephen; Chester, S. Theodore; Dollhofer, Doris; Visser, Martin; Larsen, Diane

doi:10.1016/j.vetpar.2015.12.032

Cited by 12 publications

(5 citation statements)

References 48 publications

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“…In the present field efficacy study, afoxolaner (NexGard ® ) and afoxolaner plus milbemycin oxime (NexGard Spectra ® ) oral chewable tablets demonstrated high efficacy against canine sarcoptic mange, as was previously shown in the evaluation of the two products against infestation with Dermacentor reticulatus ticks [31]. With milbemycin oxime added to afoxolaner in order to extend the ectoparasiticidal spectrum of NexGard ® to the treatment of intestinal nematode infections [16, 30, 34], and to the prevention of heartworm disease and Angiostrongylus vasorum lungworm infection [23, 35], NexGard Spectra ® chewable tablets contain two compounds with miticidal activity. However, in order to achieve therapeutic efficacy against sarcoptic mange, milbemycin oxime requires frequent repeated oral administration at elevated dosages [26].…”

Section: Discussionsupporting

confidence: 61%

Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany

Hampel¹,

Knaus

Schäfer³

et al. 2018

Parasite

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The efficacy of NexGard® and NexGard Spectra® against sarcoptic mange in dogs was evaluated in a clinical field study. Skin scrapings from dogs presenting signs suggestive of sarcoptic mange were examined to confirm infestation. A total of 106 dogs were screened at eight sites in Portugal and Germany. In all, 80 dogs that had demonstrated ≥5 live Sarcoptes mites in five skin scrapings were enrolled, scored for specific clinical signs (pruritus; papules and crusts; alopecia), and allocated at random to receive either NexGard® or NexGard Spectra® twice, one month apart per label instructions. To determine efficacy, live Sarcoptes mites in five skin scrapings per dog were counted, and clinical signs were scored one month and two months after first treatment and compared to pre-treatment (baseline) values. Based on compliance, 65 dogs were determined to be evaluable cases at the end of the study. The efficacy, in terms of reduction of geometric mean live Sarcoptes mite counts, was 98.9% and 99.7% for NexGard®-treated (n = 38) and 99.6% and 100% for NexGard Spectra®-treated dogs (n = 27) at one month and two months after treatment initiation (p < 0.001, both treatments). Both treatments resulted in a significant improvement in pruritus, papules and crusts, and alopecia one month and two months after treatment initiation (p = 0.0001, both treatments). In conclusion, this field study confirms that both NexGard® and NexGard Spectra® administered twice one month apart provide an effective and safe treatment against sarcoptic mange in dogs.

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Section: Discussionsupporting

confidence: 61%

Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany

Hampel¹,

Knaus

Schäfer³

et al. 2018

Parasite

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“…Milbemycin oxime PK parameters were determined following the administration of afoxolaner plus milbemycin oxime combination chewables ( NexGard Spectra ) in Study PK1 and compared to PK parameters for milbemycin oxime following the administration of milbemycin oxime‐alone tablets ( Interceptor ) in Study PK2 (Table ). The milbemycin oxime t 1/2 , C max , C last and AUC for each product were within one standard deviation of each other, indicating that the presence of afoxolaner does not change the PK profile of milbemycin oxime and thus provides the expected efficacy against canine gastrointestinal nematodes (Rehbein et al ., ). The C max was slightly lower for the milbemycin oxime‐alone formulation most likely because the bioavailability from the hard tablet was, on average, slightly lower than from NexGard Spectra chewable.…”

Section: Discussionmentioning

confidence: 97%

The intravenous and oral pharmacokinetics of afoxolaner and milbemycin oxime when used as a combination chewable parasiticide for dogs

Letendre¹,

Harriman²,

Drag³

et al. 2016

Vet Pharm & Therapeutics

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The pharmacokinetics of afoxolaner and milbemycin oxime (A3 and A4 forms) in dogs were evaluated following the oral administration of NexGard Spectra (Merial), a fixed combination chewable formulation of these two active pharmaceutical ingredients. Absorption of actives was rapid at levels that provide the minimum effective doses of 2.5 mg/kg and 0.5 mg/kg of afoxolaner and milbemycin oxime, respectively. The time to maximum afoxolaner plasma concentrations (t ) was 2-4 h. The milbemycin t was 1-2 h. The terminal plasma half-life (t ) and the oral bioavailability were 14 ± 3 days and 88.3% for afoxolaner, 1.6 ± 0.4 days and 80.5% for milbemycin oxime A3 and 3.3 ± 1.4 days and 65.1% for milbemycin oxime A4. The volume of distribution (V ) and systemic clearance (Cls) were determined following an IV dose of afoxolaner or milbemycin oxime. The V was 2.6 ± 0.6, 2.7 ± 0.4 and 2.6 ± 0.6 L/kg for afoxolaner, milbemycin oxime A3 and milbemycin oxime A4, respectively. The Cls was 5.0 ± 1.2, 75 ± 22 and 41 ± 12 mL/h/kg for afoxolaner, milbemycin oxime A3 and milbemycin oxime A4, respectively. The pharmacokinetic profile for the combination of afoxolaner and milbemycin oxime supports the rapid onset and a sustained efficacy for afoxolaner against ectoparasites and the known endoparasitic activity of milbemycin oxime.

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“…If confirmed, the obvious one-health benefit of the use of NexGard Spectra ® in dogs in relation to tungiasis may be further sustained by its nematicidal spectrum that includes several other zoonotic agents for which dogs are a reservoir [ 41 ]. For example, Ancylostoma spp.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of an oral formulation of afoxolaner and milbemycin oxime against Tunga penetrans in naturally infected dogs

dos Santos,

Tielemans,

Cutolo

et al. 2023

Parasites Vectors

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Background The sand flea Tunga penetrans is one of the agents of tungiasis, an important parasitic skin disease affecting humans and several mammalian species. Tungiasis is mainly observed in disadvantaged rural and peripheral urban communities in Latin America and sub-Saharan Africa. The dog is a major reservoir of Tunga fleas. Hematophagous adult female Tunga spp. embed and grow in their host’s epidermis and cause cutaneous inflammatory disorders. NexGard Spectra® is an orally administered endectocide for dogs, a co-formulation of the isoxazoline afoxolaner and the macrocyclic lactone milbemycin oxime. The objective of this study was to assess the efficacy of this product against canine tungiasis. Methods A blinded, negative-controlled field trial was conducted in a Brazilian community known to be highly endemic for tungiasis. Sixty-six dogs naturally infected with live T. penetrans were randomly allocated to a treated group (44 dogs) and an untreated control group (22 dogs). In a first phase, dogs from the treated group were treated on days 0, 30, and 60. Efficacy was evaluated on the basis of the macroscopic parasitic skin lesions (Fortaleza classification) on days 7, 14, 21, 30, 45, 60, 75, and 90. In a second phase, to evaluate natural reinfections, all dogs were treated on day 90 and evaluated every 2 weeks thereafter until at least 30% of dogs were infected with live sand fleas. Results During the first phase, efficacy (reduction in live sand fleas) of 92.4% was demonstrated on day 7. From day 14 until day 90, the efficacy of NexGard Spectra® was 100%. In the second phase, all dogs were free of live T. penetrans from 15 until 45 days after the day 90 treatment; 60 days post-treatment, 11% of dogs were reinfected, and 75 days post-treatment, 40% of dogs were reinfected. Conclusions NexGard Spectra® was demonstrated to be highly effective against canine tungiasis. In addition to an obvious beneficial effect on the health and welfare of the treated dog, the use of this product may have a one-health benefit on human cases by controlling the main reservoir of sand fleas. Graphical Abstract

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Efficacy of afoxolaner plus milbemycin oxime chewable tablets against naturally acquired intestinal nematodes in dogs

Cited by 12 publications

References 48 publications

Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany

Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany

The intravenous and oral pharmacokinetics of afoxolaner and milbemycin oxime when used as a combination chewable parasiticide for dogs

Efficacy of an oral formulation of afoxolaner and milbemycin oxime against Tunga penetrans in naturally infected dogs

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Efficacy of afoxolaner plus milbemycin oxime chewable tablets against naturally acquired intestinal nematodes in dogs

Cited by 12 publications

References 48 publications

Treatment of canine sarcoptic mange with afoxolaner (NexGard®) and afoxolaner plus milbemycin oxime (NexGard Spectra®) chewable tablets: efficacy under field conditions in Portugal and Germany

Treatment of canine sarcoptic mange with afoxolaner (NexGard®) and afoxolaner plus milbemycin oxime (NexGard Spectra®) chewable tablets: efficacy under field conditions in Portugal and Germany

The intravenous and oral pharmacokinetics of afoxolaner and milbemycin oxime when used as a combination chewable parasiticide for dogs

Efficacy of an oral formulation of afoxolaner and milbemycin oxime against Tunga penetrans in naturally infected dogs

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Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany

Treatment of canine sarcoptic mange with afoxolaner (NexGard^®) and afoxolaner plus milbemycin oxime (NexGard Spectra^®) chewable tablets: efficacy under field conditions in Portugal and Germany