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News Article

Systematic review of the effectiveness and safety of anti-epileptic drugs in cats


The level of evidence in feline epilepsy treatment is weak

Researchers from Ghent University, University of Veterinary Medicine, Vienna (Vetmeduni Vienna) and the Royal Veterinary College (RVC) have found that testing anti-epileptic drugs’ effectiveness and safety for cats has been generally subpar, worse than what was formerly reported in dogs.

By reviewing vast amounts of data, the researchers found that much of the evidence for the medical treatment of feline epilepsy was based on below-par reporting of efficacy and adverse effect. It is hoped that these findings, published in BMC Veterinary Research, will inform practices going forward, highlight the need for more high quality evidence and, by extension, improve the treatment that epileptic cats receive.

The aim of the study was to assess the efficacy and adverse effect profile of each individual anti-epileptic drug (AED) by analysing all available data published and then evaluating how reliable it was.

The researchers gathered, screened and assessed all the information published in peer-reviewed journals and publications. The individual studies were then evaluated based on the quality of evidence, study design, study group sizes, subject enrolment quality and overall risk of bias, as well as the efficacy and safety outcome measures.

Lead-author of the study, Marios Charalambous from Ghent University, said: "We recruited systematic methods to combine, compare and summarise the results of independent studies and, therefore, create more objective and reliable conclusions based on the current evidence. It was a time-consuming, demanding and challenging process, and we hope we provided the clinicians now with essential information which they can use for daily practice".

The researchers note in the article, “Current evidence did not allow comparisons among AEDs, and therefore it would be rather inaccurate to make definite statements on which one should be considered as a first or second choice in terms of both efficacy and safety profile. However, if clinicians focus on AED’s efficacy, phenobarbital can be used as first-choice monotherapy and if they focus on AED’s safety, imepitoin or levetiracetam can be used.”

Dr Akos Pakozdy, feline epilepsy specialist from Vetmeduni Vienna, commented: “We hope that this landmark paper will be one of the first steps in bringing evidence-based medicine into practice.”

Dr Sofie Bhatti, epilepsy specialist from Ghent University echoed his comment: “More publications and collaborative research is needed to help close the gap between evidence-based medicine and clinical practice”.

Holger Volk, Head of the Department Clinical Science and Services and Professor of Veterinary Neurology and Neurosurgery at the RVC, summarised: “Not only does this study offer a new perspective on the management of feline epilepsy, but also highlights the importance of the need for trials which provide high quality evidence in order to have more reliable and objective results about the efficacy and safety of the AEDs in feline epilepsy.”

Read article: Systematic review of antiepileptic drugs’ safety and effectiveness in feline epilepsy by Marios Charalambous, Akos Pakozdy, Sofie F. M. Bhatti and Holger A. Volk, published in BMC Veterinary Research (2018) 14:64, doi: 10.1186/s12917-018-1386-3

Article details

  • Date
  • 13 March 2018
  • Source
  • Royal Veterinary College
  • Subject(s)
  • Dogs, Cats, and other Companion Animals