The EPIC study (Evaluation of
Pimobendan In Cardiomegaly) found pimobendan extended the asymptomatic period by an average of 15 months, while dogs that received the drug also lived significantly longer than those receiving a placebo.
The trial, titled «Effect of
Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease (MMVD) and Cardiomegaly» (EPIC), is the largest clinical study ever to be conducted in veterinary cardiology.
Groundbreaking results of the EPIC (Evaluation of
Pimobendan In dogs with Cardiomegaly) Study, the largest veterinary cardiology study in history, are now published.
The EPIC (Evaluation of
Pimobendan In dogs with Cardiomegaly) Study1 analysed whether long - term administration of pimobendan to dogs with stage B2 myxomatous mitral valve disease (MMVD) and echocardiographic and radiographic evidence of cardiac enlargement will delay onset of clinical signs of congestive heart failure (CHF), cardiac - related death, or euthanasia (composite primary endpoint).
The EPIC (Evaluation of
Pimobendan In dogs with Cardiomegaly) Study marks the largest veterinary cardiology study in history.
The EPIC Study showed a significant benefit in administering
pimobendan in dogs with preclinical myxomatous mitral valve disease (MMVD)-- before the onset of congestive heart failure (CHF) cardiac - related death, or euthanasia (composite primary endpoint).
Effect of
pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC Study - a randomized clinical trial.
Effect of
Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial.
This is because the recently published EPIC1 study showed that early treatment with
pimobendan in MVD Stage B2 dogs will delay the development of symptoms of congestive heart failure (CHF) by an average of 15 months.
To determine whether chronic oral administration of
pimobendan in dogs with evidence of increased heart size secondary to preclinical myxomatous mitral valve disease (MMVD) can delay the onset of clinical signs of congestive heart failure (CHF).1
Pimobendan in heart failure — a silver bullet?
Not exact matches
These encouraging results led us to believe that
pimobendan could be effective
in preclinical mitral valve disease and that the investigation of this through the EPIC Study was useful and worthwhile.
In a study completed in the UK, Doberman Pinschers treated with pimobendan lived 6 times longer than those treated with an ACE inhibitor (329 days vs 50 days)
In a study completed
in the UK, Doberman Pinschers treated with pimobendan lived 6 times longer than those treated with an ACE inhibitor (329 days vs 50 days)
in the UK, Doberman Pinschers treated with
pimobendan lived 6 times longer than those treated with an ACE inhibitor (329 days vs 50 days).7
In the QUEST Study,
pimobendan significantly increased the survival time of dogs with congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD).
The EPIC Study showed that administration of
pimobendan resulted
in a 15 ‑ month delay
in time to primary endpoint compared with dogs receiving placebo.
In a study of Doberman Pinschers, 80 % of the dogs treated with pimobendan showed improvements in the quality ‑ of ‑ life measures (including exercise tolerance, coughing, dyspnea, and fatigue) compared with only 10 % in the group not treated with pimobendan
In a study of Doberman Pinschers, 80 % of the dogs treated with
pimobendan showed improvements
in the quality ‑ of ‑ life measures (including exercise tolerance, coughing, dyspnea, and fatigue) compared with only 10 % in the group not treated with pimobendan
in the quality ‑ of ‑ life measures (including exercise tolerance, coughing, dyspnea, and fatigue) compared with only 10 %
in the group not treated with pimobendan
in the group not treated with
pimobendan.7
Effect of
pimobendan or benazepril hydrochloride on survival times
in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST Study.
Investigators participating
in the EPIC Study researched whether
pimobendan was effective
in the preclinical stages of mitral valve disease.
An inodilator (eg,
pimobendan) is an agent that has both vasodilatory and positive inotropic properties
in a single medication.
In the EPIC Study, dogs in the pimobendan group experienced 10 % more life without congestive heart failure (CHF) signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 year
In the EPIC Study, dogs
in the pimobendan group experienced 10 % more life without congestive heart failure (CHF) signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 year
in the
pimobendan group experienced 10 % more life without congestive heart failure (CHF) signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 years.
The
pimobendan ‑ treated dogs showed significantly greater improvements at day 56
in demeanour, exercise tolerance, and respiratory effort compared with dogs that were not treated with
pimobendan.6
In the VetSCOPE Study, pimobendan rapidly improved the quality of life in dogs with CHF caused by myxomatous mitral valve disease (MMVD
In the VetSCOPE Study,
pimobendan rapidly improved the quality of life
in dogs with CHF caused by myxomatous mitral valve disease (MMVD
in dogs with CHF caused by myxomatous mitral valve disease (MMVD).
The EPIC Study showed that administration of
pimobendan resulted
in a 15 ‑ month delay
in onset of clinical signs of CHF, cardiac ‑ related death, or euthanasia compared with dogs receiving placebo.
BUT, we now know from the PROTECT2 study that
in Dobermanns with early - stage DCM (i.e. heart enlargement on ultrasound but no symptoms of CHF), treatment with
pimobendan delays the onset of CHF by an average of 9 months.
Survival was extended by 91 %
in dogs receiving
pimobendan compared with those receiving benazepril hydrochloride.2 *
QUEST stands for Quality of Life and Extension of Survival Time, and was an international, multi-centre clinical study comparing 2 treatments used to combat CHF
in dogs,
pimobendan and an ACE inhibitor (benazepril hydrochloride).2
As a balanced vasodilator,
pimobendan dilates both veins and arteries resulting
in a reduction
in preload and afterload.
Median time to composite primary endpoint was 1228 days
in the
pimobendan group and 766 days
in the placebo group (P = 0.0038).
Pimobendan is proven to decrease preload and afterload, and this, in combination with pimobendan's inotropic properties, may result in a reduction in cardiac size and filling pressures in dogs with significant cardiac remodelling secondar
Pimobendan is proven to decrease preload and afterload, and this,
in combination with
pimobendan's inotropic properties, may result in a reduction in cardiac size and filling pressures in dogs with significant cardiac remodelling secondar
pimobendan's inotropic properties, may result
in a reduction
in cardiac size and filling pressures
in dogs with significant cardiac remodelling secondary to MMVD.
Pimobendan is an inodilator and is the first of a unique class of treatments for congestive heart failure (CHF)
in dogs.
Pimobendan also significantly improves the quality of life
in dogs with CHF caused by DCM.
The authors of the publication conclude: «This study offers the most compelling evidence to date demonstrating the beneficial effect of
pimobendan when compared with benazepril for extending survival
in dogs with CHF caused by MMVD when used
in conjunction with other standard therapy.»
In the EPIC Study, dogs in the pimobendan group experienced 60 % more time in asymptomatic stage B2 of heart disease and 10 % more life without CHF signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 year
In the EPIC Study, dogs
in the pimobendan group experienced 60 % more time in asymptomatic stage B2 of heart disease and 10 % more life without CHF signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 year
in the
pimobendan group experienced 60 % more time
in asymptomatic stage B2 of heart disease and 10 % more life without CHF signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 year
in asymptomatic stage B2 of heart disease and 10 % more life without CHF signs that impact quality of life (10 % more life without CHF was calculated based on an estimated lifespan for all small to medium ‑ sized dogs being 12.5 years.
Patients
in Dr. Tyrell's practice have gotten years of quality life because of treatment with
Pimobendan, and one study suggests its use
in the IWH prior to the onset of congestive heart failure.
This groundbreaking study sought to answer a key question: Can
pimobendan — with proven efficacy
in treating dogs with congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD)-- also delay the onset of CHF caused by MMVD?
Pimobendan is an expensive drug but it can improve survivability
in dogs with DCM.
Recent results from the EPIC Study, however, show that
pimobendan, when administered to dogs
in stage B2 — before clinical signs of heart failure appear — succeeded
in delaying the onset of CHF.
O'Grady MR, Minors SL, O'Sullivan ML, Horne R. Effect of
pimobendan on case fatality rate
in Doberman pinschers with congestive heart failure caused by dilated cardiomyopathy.
The aim of this study was to evaluate the efficacy of
pimobendan with conventional therapies on survival and reocurrence of pulmonary edema
in dogs with congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD).
Dogs
in the standard - dose and low - dose
pimobendan groups had significantly longer median survival times than dogs
in the conventional group (334, 277 and 136 days, respectively; P < 0.001).
Drugs commonly used are diuretics (e.g. furosemide to remove fluid that has accumulated
in the abdomen or lungs and can cause your dog to drink more water and urinate more), angiotensin - converting enzyme inhibitors (ACE inhibitors to relax blood vessels to allow more efficient blood flow from the heart and to ease the workload on the heart) and positive inotropic agents (e.g.
pimobendan to increase the strength of contractility of the heart muscle tissue).
There was no difference
in survival between dogs administered standard and low doses of
pimobendan, but
pimobendan did prevent the reoccurrence of pulmonary edema
in a dose - dependent manner.
Dogs and cats with this problem are put on diuretics (furosemide = Lasix) to remove excess fluid from the body, and drugs to decrease the work load on their heart (enalapril = Enacard = Vasotec or similar meds) and medications to give the heart added strength
in its contractions (
pimobendan = Vetmedin).
The 360 canine patients enrolled
in the trial randomly received
pimobendan or a placebo, with 180 dogs
in each group.
This license extension follows the results of a clinical trial — the so called EPIC trial — which studied the effect of
pimobendan (the active ingredient
in...
Pimobendan also opens the blood vessels which return blood to the heart, reducing pressure on the heart Often used
in conjunction with other drugs Reasons for prescribing:
Pimobendan is not for use
in humans.
Effect of
pimobendan or benazepril hydrochloride on survival times
in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study.
Clinical efficacy of
pimobendan versus benazepril for the treatment of acquired atrioventricular valvular disease
in dogs.
Although currently off - label, inodilators like
pimobendan have shown to be well tolerated and prolong survival
in cats with CHF with hypertrophic cardiomyopathy as well as restrictive and dilated cardiomyopathy.