A prospective, randomized, placebo-controlled, double-blinded clinical trial comparing the incidence and severity of gastrointestinal adverse events in dogs with cancer treated with piroxicam alone or in combination with omeprazole or famotidine

Access the article

Shaevitz, M.H. et al (2021) A prospective, randomized, placebo-controlled, double-blinded clinical trial comparing the incidence and severity of gastrointestinal adverse events in dogs with cancer treated with piroxicam alone or in combination with omeprazole or famotidine. Journal of the American Veterinary Medical Association, 259 (4), pp385-391. https://doi.org/10.2460/javma.259.4.38.

Summary

The aim of this randomised placebo-controlled, double-blinded trial was to assess the impact of prophylactic administration of omeprazole or famotidine on the incidence and severity of gastrointestinal adverse events in dogs with cancer treated with piroxicam.

While this study looks at the use of gastroprotectants in a very specific situation it does provide  some evidence of the potential risks of using gastroprotectants. We have therefore included it as a paper for discussion as having looked at the evidence in this paper readers may wish to consider the broader implications.

The October 2021 edition of inFOCUS contains a summary of this paper.

Support with assessing the relevance of this paper

We have produced a guide that you can use to work through this paper as a practice.  For those less confident in assessing published papers there is a partially completed guide.

For those new to journal clubs, we have a step-by-step guide you might find useful: Setting up and running a journal club

Further reading

Marks, S.L. et al (2018)ACVIM consensus statement: support for rational administration of gastrointestinal protectants to dogs and cats. Journal of Veterinary Internal Medicine, 32 (6), pp. 1823-1840. https://doi.org/10.1111/jvim.15337

LeBlanc, A.K., et al (2021) Veterinary Cooperative Oncology Group—Common Terminology Criteria for Adverse Events (VCOG‐CTCAE v2) following investigational therapy in dogs and cats. Veterinary and Comparative Oncology, 19 (2), pp. 311-352.  https://doi.org/10.1111/vco.12677

Hunt, J.R. et al (2015) An analysis of the relative frequencies of reported adverse events associated with NSAID administration in dogs and cats in the United Kingdom. The Veterinary Journal, 206 (2), pp. 183-190. https://doi.org/10.1016/j.tvjl.2015.07.025