A Pilot Study of Long-term, Lower Dose Meloxicam Therapy in Osteoarthritic Dogs
Background & Aims
Nonsteroidal anti-inflammatory drug (NSAID) dose titration to the lowest effective dose has been recommended to mitigate potential adverse drug events while maintaining improvements in quality of life when treating canine osteoarthritis (OA).1 The purpose of this pilot study was to evaluate a downward dose titration protocol for meloxicam in a small number of OA clinical dogs.
Methods
Dogs were evaluated at D0, D60, and D120 by force plate analysis, orthopaedic examination and owner subjective assessment.2 Dose titration was begun on D60 and was stabilized at 50% of label dose (0.05 mg/kg/day) for at least 6 weeks prior to study conclusion (D120).
Results
Of the 16 dogs entering the study, full data analysis was available for 7 and is summarized in the table. The peak vertical force continually improved over the course of the study and was statistically significant at D60 (n=16) and D120 (n=7) compared to D0. While orthopaedic assessment was not statistically significant at D60 and D120 compared to D0, owner assessment was significantly better at both of these time periods. None of the dogs experienced any drug-related side effects.
Conclusion
This study supports the anecdotal information that, following initial case management using the 0.1 mg/kg label dose, up to 50% meloxicam label dose titration can be effective in controlling chronic OA. However, this should be confirmed in a larger population of dogs to further investigate the inter-animal variation in response to therapy. Moreover, subjective assessment methods need to be refined to improve sensitivity and better detect clinical OA improvements.
Table 1. Gait analysis and subjective assessments recorded in osteoarthritic dogs.
Dose titration was begun on D60 and achieved 50% of label dose (0.05 mg/kg/day) at least 6 weeks prior to study conclusion (D120).
|
|
Values are expressed in mean ± SD (n=7) |
|
Gait analysis parameters |
D0 |
D60 |
D120 |
|
Vertical force |
|
--Peak (% BW) |
60.79 ± 20.42 |
75.30 ± 21.60 |
80.60 ± 31.48* |
|
--Impulse (% BW x second) |
9.26 ± 2.68 |
11.25 ± 2.83 |
11.94 ± 4.36 |
|
Cranial force |
|
--Peak (% BW) |
6.12 ± 5.54 |
8.00 ± 5.19 |
8.38 ± 7.07 |
|
--Impulse (% BW x second) |
0.47 ± 0.56 |
0.65 ± 0.53 |
0.69 ± 0.71 |
|
Caudal force |
|
--Peak (% BW) |
6.70 ± 1.03 |
7.55 ± 2.37 |
7.66 ± 2.10 |
|
--Impulse (% BW x second) |
0.59 ± 0.12 |
0.65 ± 0.24 |
0.67 ± 0.24 |
|
Assessment scores |
|
Orthopaedic |
7.4 ± 2.5 |
7.1 ± 1.6 |
7.7 ± 1.1 |
|
Owner |
21.1 ± 10.9 |
12.0 ± 5.9* |
12.0 ± 6.1* |
BW Body weight
* Values significantly different over Day 0. A two-sided probability value (P<0.05) was considered statistically significant using Wilcoxon signed-rank test
References
1. FDA Veterinarian; March/April 2004
2. Moreau M, Dupuis J, Bonneau NH, Desnoyers M. Clinical evaluation of a nutraceutical, carprofen, and meloxicam for the treatment of dogs with osteoarthritis. Vet Rec 2003;153:323-329