Immune-mediated polyarthritis in dogs: Are corticosteroids the best bet?

PICO QUESTION: In dogs with type I immune-mediated polyarthritis (IMPA), is sole treatment with other immunosuppressive agents as effective as treatment with corticosteroids at reducing clinical signs?

CATEGORY OF RESEARCH: Treatment.

NUMBER AND TYPE OF STUDY DESIGNS REVIEWED: One pragmatic open-label randomised controlled clinical trial.

STRENGTH OF EVIDENCE: Weak.

OUTCOMES REPORTED: In the single randomised controlled clinical trial reviewed, 7/10 (70%) of dogs in both treatment groups (prednisone or cyclosporine), were reported to have shown resolution of owner-reported symptoms, clinical symptoms and improved locomotor scores and cytologic signs of disease at the end of the 90 day trial period. Of the remaining dogs, 2/3 cyclosporine treated dogs required change to prednisone, and 2/3 prednisone treated dogs required combination therapy to achieve clinical response.

CONCLUSION

There is insufficient evidence to support the use of alternative immunosuppressive agents in place of corticosteroids for the treatment of IMPA type I. Further controlled clinical trials are needed before a change to clinical practice can be considered.