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

Bacek, Lenore M.; Macintire, Douglass K.

doi:10.1111/j.1476-4431.2011.00642.x

Cited by 6 publications

(15 citation statements)

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“…, Ginel et al . , Bacek & Macintire ). Its use with prednisolone in canine idiopathic IMHA induced resolution of anaemia in seven of eight dogs, with mild enteritis seen in 1 dog (Nielsen 2005).…”

Section: Discussionmentioning

confidence: 97%

“…, Abelson 2009, Dewey et al . , Bacek & Macintire ). Canine studies show rapid oral absorption with significant enterohepatic circulation with oral bioavailability reported as 54, 65 and 87% after 10, 15 and 20 mg/kg oral dosing, respectively (Langman et al .…”

Section: Introductionmentioning

confidence: 97%

“…Adverse events reported in dogs and cats include weight loss, diarrhoea, papillomatosis and allergic reactions (Hood & Zarembski , Yu et al . , Bacek & Macintire ). Purported advantages of MMF over other immunosuppressive drugs include the availability of oral and parenteral forms, rapid onset of action and lack of myelosuppression or hepatotoxicity (Langman et al .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of canine idiopathic immune‐mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)

Wang

Smith

Creevy

2013

J of Small Animal Practice

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Treatment of canine idiopathic immune‐mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)

Wang

Smith

Creevy

2013

J of Small Animal Practice

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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, ; Bacek & Macintire, ; Machka et al., ; Segev, Cowgill, Heiene, Labato, & Polzin, ; Yau & Bianco, ).…”

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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“…Mycophenolate appears to promote less toxicity (including myelotoxicity and hepatotoxicity) than alkylating agents, which affect all tissues with a high proliferative or mitotic activity . Mycophenolate has been used in veterinary therapeutics as a treatment for myasthenia gravis, aplastic anemia, and immune‐mediated hemolytic anemia . Gastrointestinal adverse effects including anorexia, vomiting, and diarrhea are reported to be the main adverse effect of this drug; however, they usually are reversible upon dose reduction or withdrawal of the drug .…”

Section: Drug Options For Immunosuppressive Therapy Of Glomerular Dismentioning

confidence: 99%

Consensus Recommendations for Immunosuppressive Treatment of Dogs with Glomerular Disease Based on Established Pathology

Segev

Cowgill

Heiene

et al. 2013

Veterinary Internal Medicne

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The purpose of this report was to provide consensus recommendations for the use of immunosuppressive therapy in dogs with active glomerular diseases. Recommendations were developed based on comprehensive review of relevant literature on immunosuppressive therapy of glomerular disease in dogs and humans, contemporary expert opinion, and anecdotal experience in dogs with glomerular disease treated with immunosuppression. Recommendations were subsequently validated by a formal consensus methodology. The Study Group recommends empirical application of immunosuppressive therapy for dogs with severe, persistent, or progressive glomerular disease in which there is evidence of an active immunemediated pathogenesis on kidney biopsy and no identified contraindication to immunosuppressive therapy. The most compelling evidence supporting active immune-mediated mechanisms includes electron-dense deposits identified with transmission electron microscopic examination and unequivocal immunofluorescent staining in the glomeruli. For diseases associated with profound proteinuria, attendant hypoalbuminemia, nephrotic syndrome, or rapidly progressive azotemia, single drug or combination therapy consisting of rapidly acting immunosuppressive drugs is recommended. The Study Group recommends mycophenolate alone or in combination with prednisolone. To minimize the adverse effects, glucocorticoids should not be used as a sole treatment, and when used concurrently with mycophenolate, glucocorticoids should be tapered as quickly as possible. For stable or slowly progressive glomerular diseases, the Study Group recommends mycophenolate or chlorambucil alone or in combination with azathioprine on alternating days. Therapeutic effectiveness should be assessed serially by changes in proteinuria, renal function, and serum albumin concentration. In the absence of overt adverse effects, at least 8 weeks of the rapidly acting nonsteroidal drug therapy and 8-12 weeks of slowly acting drug therapy should be provided before altering or abandoning an immunosuppressive trial.

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

Cited by 6 publications

References 0 publications

Treatment of canine idiopathic immune‐mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)

Treatment of canine idiopathic immune‐mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011)

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

Consensus Recommendations for Immunosuppressive Treatment of Dogs with Glomerular Disease Based on Established Pathology

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