title: An analysis of the relative frequencies of reported adverse events associated with NSAID administration in dogs and cats in the United Kingdom.
abstract: This study aimed to analyse UK pharmacovigilance data to quantify adverse events (AEs) associated with the non-steroidal anti-inflammatory drug (NSAID) molecules found in veterinary medicines authorised for use in dogs and cats. It was hypothesised that the frequency of AEs would be lower when associated with cyclo-oxygenase-2 selective (coxib), compared to non-selective (non-coxib) NSAIDs. The UK Veterinary Medicines Directorate (VMD) supplied frequencies of AEs derived from Periodic Safety Update Reports subdivided by formulation and species for each NSAID molecule. Frequencies of AEs were similar between species. The five most reported AEs were emesis, death, anorexia, lethargy, and diarrhoea. Reported frequency of emesis, renal insufficiency and death was higher with injectable compared to oral NSAIDs (P = 0.043). Reported frequency of emesis, lethargy and death was higher with coxib, compared to non-coxib NSAIDs (P = 0.029). Median (range) interval since authorisation was shorter for coxibs at 5 (2.5-9) years compared to non-coxibs at 15 (12-25) years. A negative correlation between time elapsed since authorisation and the frequency of AEs was identified (rs = -0.11 to -0.94). Higher frequency of reported AEs with injectable NSAIDs may be related to perioperative administration. The AE frequency associated with coxib and non-coxib NSAIDs may be confounded by changes in reporting habits over time. This study highlights the value of interrogating passive surveillance data to identify low frequency AEs and the need to facilitate improvement in recording and collecting AEs in small animal practice.
authors.affiliation: University of Bristol, School of Veterinary Sciences, Langford BS40 5DU, UK. Electronic address: lvjrh@bris.ac.uk.
authors.forename: James R
authors.initials: JR
authors.lastname: Hunt
authors.affiliation: Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Dean
authors.affiliation: Pharmacovigilance Unit, Veterinary Medicines Directorate, Woodham Lane, New Haw, Addlestone, Surrey KT15 3LS, UK.
authors.forename: Giles N D
authors.initials: GN
authors.lastname: Davis
authors.affiliation: University of Bristol, School of Veterinary Sciences, Langford BS40 5DU, UK.
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Murrell
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000145:classification; D002371:Cat Diseases / Q000139:chemically induced* / Q000453:epidemiology; D002415:Cats; D004283:Dog Diseases / Q000139:chemically induced* / Q000453:epidemiology; D004285:Dogs; D013045:Species Specificity; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Adverse event; Cat; Dog; NSAID; Pharmacovigilance