Peer-reviewed veterinary case report
Azathioprine does not improve survival in dogs with immune anemia
By Piek, Christine J et al.·Published in BMC veterinary research·2011·Department of Clinical Sciences of Companion Animals, Netherlands·View original on PubMed →
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Original publication title: Lack of evidence of a beneficial effect of azathioprine in dogs treated with prednisolone for idiopathic immune-mediated hemolytic anemia: a retrospective cohort study.
- Species:
- dog
Plain-English summary
A group of dogs with immune-mediated hemolytic anemia (IMHA), a condition where the immune system attacks red blood cells, were treated with either a combination of prednisolone and azathioprine or just prednisolone alone. The study included 222 dogs, and while both treatment groups showed similar survival rates after one year, the addition of azathioprine did not provide any significant benefit. This suggests that azathioprine may not be necessary for all dogs with IMHA, but further research is needed to confirm these findings.
People also search for: dog IMHA treatment · prednisolone for dogs · azathioprine side effects in dogs
Abstract
BACKGROUND: Azathioprine is used as an immunosuppressant in canine immune-mediated hemolytic anemia (IMHA), but this potentially toxic and carcinogenic drug has not been proven to be beneficial. The aim of this study was to determine the difference in outcome and survival of dogs with idiopathic IMHA treated with a protocol that included azathioprine and prednisolone versus a protocol that included prednisolone alone. RESULTS: The study included 222 dogs with a hematocrit lower than 0.30 L/L and either a positive Coombs' test or spherocytosis and no evidence of diseases that could trigger IMHA. The clinical and laboratory data at the time of diagnosis and the response to therapy and survival were compared in dogs treated according to the prednisolone and azathioprine protocol (AP protocol; n = 149) and dogs treated according to the prednisolone protocol (P protocol; n = 73). At study entry, the two groups were comparable, except that thrombocyte counts were significantly lower and clinical signs had been present significantly longer in the AP protocol group. No significant difference in survival was found between the two groups: the 1-year survival was 64% (95% CI 54 - 77%) in the P protocol group and 69% (95% CI 59-80%) in the AP protocol group, respectively. CONCLUSIONS: Azathioprine would appear not to be beneficial as standard treatment for all cases of IMHA; however, a blinded, randomized clinical trial is needed to establish whether outcome is different with the two treatment protocols.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/21489250/