Treatment of primary immune‐mediated hemolytic anemia with mycophenolate mofetil in two cats

Bacek, Lenore M.; Macintire, Douglass K.

doi:10.1111/j.1476-4431.2010.00606.x

Cited by 33 publications

(38 citation statements)

References 13 publications

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“…Gastrointestinal upset is also the most common side effect noted with the use of MMF in people, but additional adverse effects reported include teratogenicity, increased risk of lymphoma, allergic reactions and headaches (Braun et al . ; Bacek & Macintire ; Hoeltzenbein et al . ).…”

Section: Discussionmentioning

confidence: 99%

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

Woolcock

Wang

Haley

et al. 2016

Veterinary Medicine & Sci

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The use of mycophenolate mofetil (MMF) for a variety of immune‐mediated diseases in veterinary medicine has been described. However, there is only a small number of cases documenting its use in dogs with meningoencephalomyelitis of unknown aetiology (MUE). We hypothesized that the use of MMF and corticosteroids in dogs with MUE results in comparable survival data to other published treatment protocols and is associated with limited adverse effects. A retrospective study of medical case records of dogs clinically diagnosed with MUE recorded signalment, neuroanatomic localization, magnetic resonance imaging findings, cerebrospinal fluid analysis results, medications administered, follow‐up neurologic examinations, survival and adverse events. Variables were compared between dogs which were treated with MMF within 30 days of diagnosis (immediate group) vs. dogs in which MMF therapy was started >30 days after diagnosis (delayed group). Twenty‐five cases of MUE were identified. The overall median survival time from diagnosis was 731 days (range 43–1672 days). After 1 month of MMF treatment, 92% of dogs showed improvement on a neurological examination. There was no significant effect of any recorded parameter on survival, including delayed vs. immediate initiation of MMF treatment. Dogs with delayed treatment had significantly lower clinical remission rates than dogs with immediate treatment at 6 months after starting MMF. Adverse events were identified in two cases (8%) and were characterized by mild gastrointestinal signs (vomiting and decreased appetite). Administration of MMF appears safe in dogs with MUE. The use of MMF results in comparable survival times to alternate immunosuppressive protocols.

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Section: Discussionmentioning

confidence: 99%

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

Woolcock

Wang

Haley

et al. 2016

Veterinary Medicine & Sci

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“…The prodrug mycophenolate mofetil (MMF) has been shown to be a promising drug for the treatment of autoimmune diseases in dogs and cats (Ackermann, May, & Frank, 2017;Bacek & Macintire, 2011;Machka et al, 2014;Segev, Cowgill, Heiene, Labato, & Polzin, 2013;Yau & Bianco, 2014).…”

Section: Introductionmentioning

confidence: 99%

Ex vivo binding of the immunosuppressant mycophenolic acid to dog and cat plasma proteins and the effect of co‐incubated dexamethasone and prednisolone

Morassi

Vélez

Slovak

et al. 2018

Vet Pharm & Therapeutics

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Mycophenolic acid (MPA) has been shown to be promising for the treatment of autoimmune diseases in dogs and cats. In humans, MPA is highly bound to plasma proteins (~97%). It has been recommended to monitor free drug plasma concentrations because the free MPA correlates with its immunosuppressive effect. However, it is unknown if MPA is highly bound to plasma proteins in dogs and cats. The objectives of this study were to determine the extent of plasma protein binding of MPA and evaluate the effect of prednisolone and dexamethasone on the extent of protein binding of MPA in dogs and cats. The extent of plasma protein binding of MPA was determined in plasma collected from clinically healthy adult cats (n = 13) and dogs (n = 14) by combining high-throughput dialysis and ultra-high-liquid chromatography. This study reveals that MPA is highly bound to plasma proteins (>90%) in dogs and cats, mean extent of binding of MPA at 15 μg/ml to plasma proteins being 96% (range, 95%-97%) and 92% (range, 90%-93%) for dogs and cats, respectively. In dog plasma, MPA is primarily bound to albumin. In vitro, prednisolone increased the unbound MPA in dogs (p < .01) but not in cats (p = .07) while dexamethasone had no effect on MPA plasma binding in either species (p > .05). Results of this study provide valuable information for designing future pharmacokinetic and pharmacodynamic studies and also therapeutic monitoring programs for dogs and cats.

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“…MMF has been used in veterinary medicine for treatment of acquired myasthenia gravis, aplastic anemia, and immune‐mediated hemolytic anemia . Its beneficial effect in canine MUE was first suggested by Dewey in 2003, followed by a 5‐dog case series, but it has yet to be assessed in a larger‐scale study.…”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005–2011)

Barnoon

Shamir

Aroch

et al. 2015

J Vet Emergen Crit Care

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MMF can be used as an adjunctive treatment for dogs with MUE. This protocol enables reduction of prednisone treatment or, in some cases, its complete withdrawal. The possibility of intravenous administration is advantageous in cases with severe neurological abnormalities and mentation changes, often seen in MUE. Attention is warranted for gastrointestinal adverse effects, especially in the first 2 weeks of treatment.

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Treatment of primary immune‐mediated hemolytic anemia with mycophenolate mofetil in two cats

Abstract: This is the first reported use of oral MMF as adjunctive treatment for cats with immune-mediated hemolytic anemia. Outcome was favorable in both cats and no adverse effects were noted from the MMF.

Cited by 33 publications

References 13 publications

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012)

Ex vivo binding of the immunosuppressant mycophenolic acid to dog and cat plasma proteins and the effect of co‐incubated dexamethasone and prednisolone

Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005–2011)

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