COLLEGE STATION, Texas – Mitral valve disease (MVD) accounts for approximately 75 percent of all canine heart disease. However, a recent global clinical trial led by a Texas A&M University veterinarian was published in the Journal of Veterinary Internal Medicine (Sept 2016) and shows that early treatment can slow progression of the disease, prolonging overall survival and helping patients remain symptom free for longer.
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. The trial found pimobendan, a drug treatment, is effective in delaying the onset of clinical signs for an average of 15 months in dogs with increased heart size secondary to preclinical MMVD.
“I am excited about the results of this groundbreaking study and proud to be a part of the EPIC team,” said Dr. Sonya Gordon, associate professor at the Texas A&M College of Veterinary Medicine & Biomedical Science and a lead investigator in the EPIC clinical study. “The results of this clinical trial will change the way the most common cause of heart disease and heart failure in the dog is managed on a day-to-day basis by veterinarians around the world and contribute to dogs with MMVD living better and longer.”
The study is the largest prospective cardiology study in veterinary medicine and took place over the course of seven years. The study was terminated early following an interim analysis as the evidence was considered conclusive, and it was deemed unethical to continue to withhold treatment from the placebo group.
EPIC was an international effort run by specialized veterinary cardiologists at 36 clinical trial centers. Half of the trial centers were in the United States, while the other 18 centers were in Australia, Canada, France, Germany, Italy, Japan, the Netherlands, Spain, Sweden, and the United Kingdom. The 360 canine patients enrolled in the trial randomly received pimobendan or a placebo, with 180 dogs in each group. Gordon and her colleagues at Texas A&M; treated 16 of those dogs.
These findings will allow veterinarians to offer pimobendan as a treatment for dogs with heart enlargement as a consequence of MMVD to delay congestive heart failure and prolong survival. “Thanks to the EPIC study results, vets no longer have to adopt a ‘watch and wait’ approach to suspected preclinical cases of MVD. When a typical mitral valve murmur is detected, vets should now investigate further to look for cardiac enlargement. If demonstrated, this suggests the patient will probably benefit from treatment with pimobendan before the onset of clinical signs,” said Dr. Adrian Boswood, professor of veterinary cardiology at the Royal College of London and a lead investigator of the study.
Full and final results of the EPIC clinical study, which was sponsored by Boehringer Ingelheim, were presented for the first time the American College of Veterinary Internal Medicine Forum in June 2016 of this year.