Researchers from Royal Veterinary College (RVC) have found that the effectiveness of testing anti-epileptic drugs (AEDs) for canine epilepsy is far below the expected standard.
The RVC’s canine epilepsy clinic has carried out the first ever systematic review on the efficacy of all AEDs in canine epilepsy. The aim of the study was to assess the effectiveness of each individual AED by analysing all available data that has been published for each specific AED and then evaluating how reliable the data was.
To do this 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. The results now provide a new and more objective insight into the efficacy of the AEDs.
Co-author of the study, Marios Charalambous, said: “We had to look at the whole evidence being published, its level of perceived quality and build an integrated view for the possible efficacy of a drug.” By reviewing, assessing and untangling the vast amounts of data the researchers found that much of the evidence for the medical treatment of canine epilepsy was based on subpar testing and in studies that were below the expected standard.
Professor Holger Volk, Clinical Director of the RVC Small Animal Referral Hospital and Professor of Veterinary Neurology and Neurosurgery, said: “Not only does this study offer a new prospective about the management of canine 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 of the AEDs in veterinary medicine.”
Epilepsy is the most common chronic neurological condition found in dogs and humans. It affects around 50,000 canines in the UK and approximately 600,000 people. Epilepsy is not a specific disease but a chronic condition characterised by recurrent seizures. The most common treatment for canine epilepsy is AEDs, making this study extremely important in relation to the management of the condition.
After carrying out the systematic review the researchers could only find few studies that provided a relatively unbiased view or objective results.
Dr. Dave Brodbelt, Senior Lecturer in Companion Animal Epidemiology, said: “this systematic review revealed that, in veterinary medicine, the quality of evidence provided by the studies for AEDs’ efficacy is not yet at a recommended standard. Many studies revealed a potential efficacy of a drug, but then there was a lack of follow-up studies of higher quality confirming the initial positive results.”
To improve the level of testing for the drug treatments of canine epilepsy the study recommends that veterinary scientists should work closer together and have a more collaborative approach to their research. This will then improve the level of testing across the veterinary sector.
It also suggests a closer working relationship with funders and all major stakeholders to improve the funding structure and training provisions, as well as reducing publication bias and pressures.
The study also suggests that veterinary medicine should follow the lead of human epilepsy medical research and come together to combat the problem on a global scale. Veterinary studies could model examples like the International League Against Epilepsy which works to advance and disseminate knowledge about epilepsy, promote research, education and training and improve services and care for patients.
Prof Volk added: “Canine epilepsy is a complex condition and can be very distressing for the dog and their owners, therefore it is immensely important the drug treatments we give to our pets have been properly tested in reliable studies.”
Notes for editors
- Research reference: Charalambous M, Brodbelt D and Volk HA. Treatment in canine epilepsy – a systematic review. BMC Veterinary Research 2014, 10:257 doi:10.1186/s12917-014-0257-9
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- The Royal Veterinary College (RVC) is the England's largest and longest established veterinary school and is a constituent College of the University of London.
- The RVC offers undergraduate, postgraduate and CPD programmes in veterinary medicine and veterinary nursing and is ranked in the top 10 universities nationally for biosciences.
- The College is the only veterinary school in the world to hold full accreditation from AVMA, EAEVE, RCVS and AVBC.
- A research-led institution, the RVC ranked as the top veterinary school in the Agriculture, Veterinary and Food Science unit of the most recent Research Assessment Exercise with 55% of academics producing 'world class' and 'internationally excellent' research.
- The College also provides support for the veterinary profession through its three referral hospitals including the Queen Mother Hospital for Animals, Europe's largest small animal hospital, which sees more than 8,000 patients each year