Gertraut Altreuther

Field Evaluation of the Efficacy and Safety of Emodepside plus Praziquantel Tablets (Profender® Tablets for Dogs) against Naturally Acquired Nematode and Cestode Infections in Dogs

A controlled, blinded and randomised multicentre field study evaluated the efficacy and safety of a new anthelmintic tablet formulation containing emodepside plus praziquantel (Profender® tablets for dogs) in the treatment of gastrointestinal nematode and cestode infections in dogs in France, Germany, Portugal and Slovakia. Dogs positive for nematodes and/or cestodes (demonstrated by faecal egg counts and/or the presence of proglottids) were treated with emodepside plus praziquantel tablets (n = 239) or the reference product containing milbemycin oxime and praziquantel (Milbemax® [n = 115]) at the recommended dose rate. Two faecal samples collected between 7 and 13 days after treatment were evaluated for proglottids, nematode and cestode eggs. No suspected adverse drug reactions were observed in the study. The following parasite species were identified: Trichuris vulpis, Toxocara canis, Toxascaris leonina, Uncinaria stenocephala, Ancylostoma caninum, Dipylidium caninum, Taeniidae and Mesocestoides spp. Geometric mean nematode egg counts in dogs treated with emodepside plus prazi quantel tablets were reduced by 99.9 % compared with a reduction of 99.6 % for the reference product. Statistical analysis demonstrated noninferiority of investigational versus reference product (p = 0.0342). None of the dogs treated with emodepside plus praziquantel or reference product remained positive for cestodes after treatment. The study demonstrated that emodepside plus praziquantel tablets are safe and highly efficacious against a broad spectrum of nematodes and cestodes under field conditions.

Field evaluation of the efficacy and safety of emodepside/praziquantel spot–on solution against naturally acquired nematode and cestode infections in domestic cats

Two controlled, blinded and randomized multi–site clinical field studies evaluated the efficacy and safety of emodepside/praziquantel spot–on in the treatment of gastrointestinal nematode and cestode infections in cats. In a study conducted in Europe, faecal egg count reductions of >98% for all nematode eggs and eggs of Toxocara cati, respectively, were observed in cats treated with emodepside/praziquantel spot–on (Profender®, Bayer AG, Leverkusen, Germany). For a positivecontrol product containing selamectin (Stronghold) reductions of >95% were observed. A 100% reduction of faecal eggs and proglottids was observed in cats treated with emodepside/praziquantel spot–on that were infected with cestodes. In a study conducted in North America, cats were treated with either emodepside/praziquantel spot–on plus a placebo tablet or a combination of two control products containing, respectively, selamectin (Revolution) and epsiprantel (Cestex). Faecal egg count reduction for eggs of T. cati was >99% for both treatments. For faecal eggs and proglottids of Dipylidium caninum reductions of >99 and >97% were recorded for cats treated with emodepside/praziquantel spot–on and the control group, respectively. No adverse reactions were observed in the European study, and only mild ones of short duration in a few cats from both treatment groups of the North American study. The two studies demonstrated that emodepside/praziquantel spot–on is highly efficacious and safe under field conditions.

Evaluation of the efficacy of emodepside plus praziquantel topical solution against ascarid infections (Toxocara cati or Toxascaris leonina) in cats

Eleven controlled studies were conducted in the United States and Europe to evaluate the efficacy of a topical solution of emodepside (3 mg/kg)+praziquantel (12 mg/kg) (Profender®, Bayer AG, Leverkusen, Germany) against infection with various stages of the ascarid nematodes Toxocara cati and Toxascaris leonina. Infections were induced by administration of larvated ascarid eggs, and stage–specific efficacy was evaluated by treating cats at scheduled intervals post–inoculation. All studies featured random allocation to treatment groups, placebo–treated control animals and assessment of outcome measures by masked personnel. The product (emodepside+praziquantel topical solution) was 100% effective against mature adults and immature adult T. cati. In addition, it was 96.8% effective against third stage larvae and at least 99.4% effective against fourth stage larvae of T. cati, respectively. Efficacy against mature, immature adult and L4 stages of T. leonina exceeded 93.4%, but regulatory “adequacy of infection” criteria were not met in sorne studies. No adverse reactions to treatment were noted in cats treated with the emodepside+praziquantel topical solution.

Efficacy of Emodepside plus Praziquantel Tablets (Profender® Tablets for Dogs) against Mature and Immature Adult Ancylostoma caninum and Uncinaria stenocephala Infections in Dogs

This paper reports the efficacy of a novel flavoured tablet formulation of emodepside plus praziquantel (Profender® tablets for dogs) against mature and immature adult hookworms (Ancylostoma caninum and Uncinaria stenocephala) in dogs. The tablets were used at the minimum recommended dose of 1 mg emodepside and 5 mg praziquantel per kg body weight. Four randomised, blinded and controlled laboratory studies demonstrated >95% efficacy against mature and immature adult stages of U. stenocephala and four randomised, blinded and controlled laboratory studies demonstrated >98% efficacy against mature and immature adult stages of A. caninum. No side effects of the treatment were observed. It is concluded that the emodepside plus praziquantel tablet is an effective and safe treatment against mature and immature hookworms.

Efficacy of emodepside plus praziquantel tablets (Profender® tablets for dogs) against mature and immature infections with Toxocara canis and Toxascaris leonina in dogs.

The efficacy of emodepside plus praziquantel tablets (Profender® tablets for dogs) against mature adult, immature adult and larval stages of Toxocara canis and Toxascaris leonina was evaluated in ten randomised, blinded and placebo-controlled dose confirmation studies in naturally or experimentally infected dogs. The tablets were used at the proposed minimum dose of 1 mg emodepside and 5 mg praziquantel per kg body weight. Efficacy was calculated based on worm counts after necropsy. Five studies demonstrated >99% efficacy against mature adult, >92% efficacy against immature adult, >98% efficacy against L4 and >94% efficacy against L3 larval stages of T. canis. Another five studies demonstrated >99% efficacy against mature and immature adult and >95% efficacy against L4 larval stages of T. leonina. No side effects of the treatment were observed. Emodepside plus praziquantel tablets thus provide a comprehensive new treatment option for ascarid infections in the dog.

Efficacy of Emodepside plus Praziquantel Tablets (Profender ® Tablets for Dogs) against Mature and Immature Cestode Infections in Dogs

The efficacy of a novel flavoured tablet formulation of emodepside plus praziquantel (Profender® tablets for dogs) against intestinal cestodes was investigated in four randomised, blinded placebocontrolled dose confirmation studies in dogs experimentally infected with Echinococcus granulosus or E. multilocularis and in dogs naturally infected with Dipylidium caninum or Taenia spp. The tablets were used at the minimum recommended dose of 1 mg emodepside and 5 mg praziquantel per kg body weight. The studies demonstrated 100% efficacy against mature and immature E. granulosus and E. multilocularis and mature Taenia spp. and D. caninum. Additionally, one of the studies demonstrated non-interference of emodepside with the efficacy of praziquantel against D. caninum. No side effects of the treatment were observed. It is concluded that emodepside plus praziquantel tablets are safe and effective against mature and immature stages of E. granulosus and E. multilocularis and mature stages of Taenia spp. and D. caninum.

Efficacy of a topically administered combination of emodepside and praziquantel against mature and immature Ancylostoma tubaeforme in domestic cats

This paper reports the efficacy of emodepside/praziquantel spot–on (Profender®, Bayer AG, Leverkusen, Germany), a novel broadspectrum anthelmintic for dermal application, against L4 larvae and immature adult and adult stages of Ancylostoma tubaeforme in cats. The formulation contains 2.14% (w/w) emodepside and 8.58% (w/v) praziquantel, with emodepside being active against gastrointestinal nematodes and praziquantel against cestodes. Five randomized, blinded and controlled laboratory studies demonstrated 100% efficacy of emodepside/praziquantel spot–on against mature A. tubaeforme and an efficacy of >95% and >97%, respectively, against L4 larvae and immature adults (based on worm counts after necropsy) at approximately the minimum proposed dose rate in cats of 3.0 mg emodepside and 12.0 mg praziquantel/kg body weight. No adverse reactions to the treatment were observed. It is concluded that emodepside/praziquantel spot–on is an effective and safe treatment against infections with mature and immature A. tubaeforme. Emodepside/praziquantel spot–on will considerably facilitate the treatment of cats against nematodes and cestodes compared with orally administered preparations.

Efficacy of emodepside plus praziquantel tablets (Profender® tablets for dogs) against mature and immature adult Trichuris vulpis infections in dogs.

This paper reports on the efficacy of a novel flavoured tablet formulation of emodepside plus praziquantel (Profender® tablets for dogs) against mature and immature adult whipworms (Trichuris vulpis) at the proposed minimum dose of 1 mg emodepside and 5 mg praziquantel per kg body weight in dogs. Three randomised, blinded and controlled laboratory studies with naturally or experimentally infected dogs were performed. The first study was conducted as a dose determination study in experimentally infected dogs using three different dose levels, i.e., 0.5x, 1x and 2x the minimum therapeutic dose. Two further studies confirmed the efficacy of emodepside plus praziquantel tablets against mature and immature adult T. vulpis at the recommended minimum dose. In all three studies, the efficacy against mature and immature adult T. vulpis was >99%. No side effects of the treatment were observed. It is concluded that the emodepside plus praziquantel tablet is an effective and safe treatment against mature and immature adult stages of T. vulpis in dogs.

W A A V P guideline for evaluating the efficacy of anticoccidials in mammals (pigs, dogs, cattle, sheep)

This guideline is intended as an aid in the design, implementation and interpretation of studies for the assessment of drug efficacy against Eimeria in cattle and sheep, Cystoisospora in pigs and dogs, and Cryptosporidium in cattle. It deals with the most important aspects of how to conduct both experimental and field studies for dose determination, dose confirmation and assessment of field effectiveness. Also, guidance on the selection of animals, diagnostic techniques, statistical evaluation and methods for the preparation, maintenance and use of parasites is provided. The specific management conditions that may influence the course of natural infections and consequently determine treatment schemes are mentioned and suggestions for best practice in sampling and evaluation of data prior to conducting of efficacy studies are given. The guideline is also intended to assist investigators in carrying out specific studies, provide relevant information for registration authorities involved in the decision-making process, assist in the approval of anticoccidial drugs in the target species, and facilitate the world-wide adoption of standard procedures. Although currently not implemented, issues of drug resistance testing and alternative methods for drug testing are also discussed as future issues in drug testing against mammalian coccidia.

Efficacy of Emodepside plus Toltrazuril Oral Suspension for Dogs (Procox ® , Bayer) against Trichuris vulpis in Naturally Infected Dogs

The efficacy of emodepside plus toltrazuril oral suspension for dogs (Procox®, Bayer) against Trichuris vulpis was evaluated in a controlled, blinded and randomised laboratory study. Twenty naturally infected dogs were included. Dogs in the treatment group received the minimum therapeutic dose of 0.45 mg emodepside and 9 mg toltrazuril per kg body weight, while dogs in the control group were left untreated. Efficacy was calculated based on worm counts after necropsy on Day 7 post treatment. Additionally, all faeces were collected and examined for expelled worms. The treatment was 100 % effective. A total of 233 adult worms (geometric mean 17.0) and 3 immature adult worms were found in the control group at necropsy. Adequacy of infection was demonstrated. The treated group excreted a total of 186 adult worms within 2 days after treatment. Additionally, all dogs were co-infected with Uncinaria stenocephala. Efficacy against this parasite was 99.8 %. No side effects of the treatment were observed. This study demonstrates that in addition to the formerly proven efficacy against Toxocara canis, Ancylostoma caninum and Uncinaria stenocephala, emodepside plus toltrazuril suspension is also effective against T. vulpis and thus represents a convenient treatment option for dogs co-infected with whipworms and coccidia.