Journal of Veterinary Pharmacology and Therapeutics, Год журнала: 2025, Номер 48(2), С. 65 - 66
Опубликована: Март 1, 2025
This special issue of Journal Veterinary Pharmacology and Therapeutics was precipitated by the launch SGLT2-inhibitors onto veterinary market for treatment diabetes mellitus in cats. It is hard to overstate significance a novel oral mode given that practitioner survey found 1 10 owners will euthanise their pet because not wanting inject insulin (Niessen et al. 2017). As Drs Cook Berend comprehensively discuss this JVPT, cats are well suited with SGLT-inhibitors unlike dogs many have some residual β-cell function (Cook Behrend 2025). These drugs may also be valuable management dysregulation central feature equine metabolic syndrome associated problem, laminitis, which there currently no licensed treatments (Menzies-Gow Knowles Now been brought it seems opportune consider potential wider use renal cardiovascular disease patients (Elliott Oyama The interest these indications stems from evidence human medicine class (and does seem effect rather than being any individual drug) reduces risk major cardiac adverse events slows rate progression diabetic kidney disease. Following discoveries clinical expanded include various forms non-diabetic diseases, stemming part observation actual benefits were greater would anticipated just relatively mild weight loss decrease blood pressure. Given explosion drugs, excitement surrounding benefit humans especially considering current obesity epidemic all its serious medical sequelae, easy overlook fact positive health effects anticipated. In fact, huge trials performed FDA-mandated studies required following new glucose-lowering due concern might ADVERSE outcomes (Udell 2015). Indeed, finding detrimental, but actually improved outcomes, really quite unexpected (Zinman researcher, possible get despondent when looking at humans, feeling nothing on comparable scale ever patients. For example, recent meta-analysis reaching composite end-point End Stage Kidney Disease (ESKD), death or doubling serum creatinine concentration included over 15,000 participants treated still recorded ≤ 500 (Sridhar 2023). imagine metanalysis study size could recapitulated patients, large prohibitively expensive. However, lessons learned experiences. show value detailed rigorous studying even once they widespread use, such as occurs EMA FDA mandated post-authorisation pharmacovigilance studies. estimated about 90% drug reactions unreported, particularly if recognised side-effects, so implementing systems require surgeons take additional steps record unlikely answer (Davies 2024). Or recording only work an incentive provided, least process facilitated allow direct access patient's notes event occurring. Data mining information already collected prove more fruitful regard, now several ways developed searching patient databases. used within corporate practices (e.g., Banfield PetWare) compile data numerous participating practices; independent and/or VetCompass, SAVSNET, CAVSNET), insurance databases, countries where subscription high concentrated small number providers Sweden). Of course, good entered into them, one must accept limitations. VetCompass diagnosed Chronic (CKD) 10% cases diagnosis made solely basis physical examination, without supporting bloodwork urinalysis (Conroy 2019). inclusive criteria can both advantages disadvantages; hand appear CKD confirmed further testing, other less stringent inclusion representative general population first-opinion practices. Ultimately events, death, discontinuation drug, incontrovertible easily extracted records very informative enough populations compared have/haven't certain exposed particular event. approach has recently utilised emulate using development urinary incontinence cruciate (Pegram 2024a, 2024b). An how disrupted typical sequence knowledge acquisition treatment. Although overly simplistic tends flow regarding starting basic physiology, pharmacology pathology before, results promising, progressing different phases trials, probably animal research along way. Unexpected highly beneficial however, triggers reverse approach. A previous example anti-fibrotic mechanisms mineralocorticoid antagonists triggered remarkable survival followed addition low dose spironolactone conventional heart failure seminal RALES (Pitt 1999). likewise shown promise similarly fuelling science cell culture vitro models impact endothelial dysfunction, apoptosis, fibrosis, oxidative stress common pathophysiological turn support diseases pulmonary hypertension hepatic cirrhosis (Zhang 2025; Pradhan Somehow clinicians need try act our shorter lifespan faster rates, provide meaningful translational data—and doing 'One Medicine' Harriet M. Syme Jonathan Elliott. JE receives grant funding Boehringer Ingelheim Elanco Animal Health acted consultant companies. relevant companies SGLT2 inhibitors.
Язык: Английский