Effects of pimobendan in cats with hypertrophic cardiomyopathy and recent congestive heart failure: Results of a prospective, double-blind, randomized, nonpivotal, exploratory field study.

Abstract

BACKGROUND:

The benefits of pimobendan in the treatment of congestive heart failure (CHF) in cats with hypertrophic cardiomyopathy (HCM) have not been evaluated prospectively.

HYPOTHESIS/OBJECTIVES:

To investigate the effects of pimobendan in cats with HCM and recent CHF and to identify possible endpoints for a pivotal study. We hypothesized that pimobendan would be well-tolerated and associated with improved outcome.

ANIMALS:

Eighty-three cats with HCM and recently controlled CHF: 30 with and 53 without left ventricular outflow tract obstruction.

METHODS:

Prospective randomized placebo-controlled double-blind multicenter nonpivotal field study. Cats received either pimobendan (0.30 mg/kg q12h, n = 43), placebo (n = 39), or no medication (n = 1) together with furosemide (<10 mg/kg/d) with or without clopidogrel. The primary endpoint was a successful outcome (ie, completing the 180-day study period without a dose escalation of furosemide).

RESULTS:

The proportion of cats in the full analysis set population with a successful outcome was not different between treatment groups (P = .75). For nonobstructive cats, the success rate was 32% in pimobendan-treated cats versus 18.2% in the placebo group (odds ratio [OR], 2.12; 95% confidence interval [CI], 0.54-8.34). For obstructive cats, the success rate was 28.6% and 60% in the pimobendan and placebo groups, respectively (OR, 0.27; 95% CI, 0.06-1.26). No difference was found between treatments for the secondary endpoints of time to furosemide dose escalation or death (P = .89). Results were similar in the per-protocol sets. Adverse events in both treatment groups were similar.

CONCLUSIONS AND CLINICAL IMPORTANCE:

In this study of cats with HCM and recent CHF, no benefit of pimobendan on 180-day outcome was identified.

• Authors: Karsten E Schober, John E Rush, Virginia Luis Fuentes, Tony Glaus, Nuala J Summerfield, Kathy Wright, Linda Lehmkuhl, Gerhard Wess, Margaret P Sayer, Joao Loureiro, John MacGregor, Nicole Mohren
• Journal: Journal of veterinary internal medicine (J Vet Intern Med) Vol. 35 Issue 2 Pg. 789-800 (Mar 2021) ISSN: 1939-1676 [Electronic] United States
• PMID: 33543810 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Veterinary)
• Copyright: © 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.

Chemical References

• Cardiotonic Agents
• Pyridazines
• pimobendan

Topics

• Animals
• Cardiomyopathy, Hypertrophic (drug therapy, veterinary)
• Cardiotonic Agents (therapeutic use)
• Cat Diseases (drug therapy)
• Cats
• Dog Diseases (drug therapy)
• Dogs
• Heart Failure (drug therapy, veterinary)
• Prospective Studies
• Pyridazines