Long‐term efficacy of imepitoin in the treatment of naive dogs affected by idiopathic epilepsy

Abstract

The purpose of this study was to evaluate the long-term (12 months) efficacy and tolerability of imepitoin as first-choice treatment in 56 dogs suffering from idiopathic epilepsy and identify possible factors affecting the outcome. Primary treatment success (PTS) was defined as the achievement of a seizure-free interval three times longer than the pretreatment interictal interval (at least three months). Secondary treatment success (STS) was achieved by a decrease in seizure frequency ≥50 per cent compared with the pretreatment frequency. In the long-term follow-up, PTS was recorded in 14 (25 per cent) dogs and responder-dogs (PTS+STS) were 30 (54 per cent) showing significant reduction in the monthly average number of seizures (P<0.001). Median seizure frequency per month was 1.69 pretreatment and 0.3 at 12-month follow-up. Dogs with cluster seizures were significantly reduced (P=0.02). PTS at three and six months was associated with PTS (P=0.006 and <0.001, respectively) and with the status of responder dogs (P=0.002) at 12-month follow-up. Dogs aged >36 months at the start of imepitoin treatment had a positive association to become responder dogs (P<0.001) and achieve PTS (P=0.004). 16 dogs (29 per cent) discontinued imepitoin due to its inefficacy. The receiver operator curve highlighted ≥19 mg/kg twice a day as the most effective minimal dosage. Mild and transient side effects were observed in 16 dogs (29 per cent).

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy

“…clusters), but the number of days they occurred upon did not change. The effectiveness of imepitoin to treat dogs with cluster seizures has not been studied to date, and thus imepitoin is not recommended as a primary treatment for dogs with cluster seizures [48]. Over half of the dogs studied (55.3%, n  = 47) had experienced cluster seizures in this study despite this recommendation, with no changes in treatment efficacy found between clustering and non-clustering dogs.…”

Evaluation of Pexion® (imepitoin) for treatment of storm anxiety in dogs: A randomised, double‐blind, placebo‐controlled trial

“…The prevalence of ataxia (60%) is similar to the reported prevalence in a retrospective study on diazepam use in dogs, 14 but higher than previously reported for imepitoin for noise reactivity. Previous reports of imepitoin used in the treatment of canine epilepsy have reported mixed results with regard to adverse events; Gallucci et al noted transient adverse effects that resolved within 10 days in dogs treated for 12 months, 15 while Stabile et al found that 25% of dogs had persistent adverse effects during treatment with imepitoin (not significantly different from phenobarbital treatment). 16 Aggression -which has been noted in studies of diazepam 14 and imepitoin 16 -was reported in two dogs in the imepitoin group and one dog in the placebo group.…”

“…Previous reports of imepitoin used in the treatment of canine epilepsy have reported mixed results with regard to adverse events; Gallucci et al. noted transient adverse effects that resolved within 10 days in dogs treated for 12 months, 15 while Stabile et al. found that 25% of dogs had persistent adverse effects during treatment with imepitoin (not significantly different from phenobarbital treatment) 16 .…”

“…Indeed, imepitoin is approved in several countries (including the European Union and United Kingdom) for long-term use in the treatment of canine epilepsy, with dogs remaining on treatment for months to years. [15][16][17] McPeake and Mills 18 reviewed their use of imepitoin at a range of doses as a long-term treatment for fear-and anxiety-related problems as a case series in dogs; these included dogs with fears of noises in addition to other behavioural concerns. They found that imepitoin given twice daily, in conjunction with a behavioural modification programme was effective in the reduction of fear and anxiety scores.…”

Effects of three infusion fluids with different sodium chloride contents on steady‐state serum concentrations of bromide in dogs

“…Potassium bromide (KBr) has been frequently used for the management of idiopathic epilepsy in canine medicine (Boothe, Dewey, & Carpenter, ; Chang, Mellor, & Anderson, ). Although new canine antiepileptic drugs such as imepitoin (Gallucci et al., ; Nessler et al., ) and zonisamide (Dewey et al., ; von Klopmann, Rambeck, & Tipold, ) were approved by the European Medicines Agency (EMA) and Japan Veterinary Products Association (JVPA) respectively, the high priority of KBr in the treatment of canine epilepsy has remained unchanged for decades (Royaux et al., ; Schwartz, Munana, & Olby, ). Therapeutic bromide concentrations to suppress seizures without adverse reactions were reported from 0.81 to 2.40 mg/ml when KBr was administered in combination with phenobarbital and from 0.88 to 3.00 mg/ml when KBr was administered alone (Trepanier, Van Schoick, Schwark, & Carrillo, ).…”