Comparison of Two Regimens for the Treatment of Meningoencephalomyelitis of Unknown Etiology

Background: The optimal treatment for meningoencephalomyelitis of unknown etiology (MUE) remains unknown, despite the widespread use of a variety of immunosuppressive drugs. Objective/Hypothesis: To compare the efficacy of prednisolone combined with either vincristine and cyclophosphamide (COP group...

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Published in:Journal of veterinary internal medicine 2009-05, Vol.23 (3), p.520-526
Main Authors: Smith, P.M, Stalin, C.E, Shaw, D, Granger, N, Jeffery, N.D
Format: Article
Language:English
Subjects:
Animals
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
CSF analysis
Dog Diseases - drug therapy
Dogs
Drug Therapy, Combination
Encephalitis
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Inflammatory
Meningitis
meningoencephalitis
Meningoencephalitis - drug therapy
Meningoencephalitis - veterinary
Noninfectious
prednisolone
therapeutics
Treatment Failure
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Summary:Background: The optimal treatment for meningoencephalomyelitis of unknown etiology (MUE) remains unknown, despite the widespread use of a variety of immunosuppressive drugs. Objective/Hypothesis: To compare the efficacy of prednisolone combined with either vincristine and cyclophosphamide (COP group; n= 10) or with cytosine arabinoside (AraC group; n= 9). Animals: Nineteen dogs with neurological deficits, neuroimaging, and cerebrospinal fluid abnormalities consistent with a diagnosis of MUE. Methods: Prospective, blinded, and randomized clinical trial. Dogs fulfilling the inclusion criteria were randomly allocated to receive 1 drug regimen. Results: Four of 10 dogs in the COP group and 5/9 in the AraC group survived > 12 months but neither the survival time nor the time‐to‐treatment failure differed between the 2 groups. Treatment with COP resulted in an unacceptable incidence of adverse effects. Conclusions: The adverse effects of COP make it an unsuitable treatment for MUE. Although survival of animals treated with AraC was broadly similar to that reported in recently published studies describing this treatment, it remains unclear whether it confers any benefit over using prednisolone alone.
ISSN:0891-6640
1939-1676
DOI:10.1111/j.1939-1676.2009.0299.x