Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Randomized Clinical Trial Comparing Itraconazole and the Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis

Erica Guerino dos Reis
ORCID logo ,
Sandro Antonio Pereira
ORCID logo ,
Luisa Helena Monteiro De Miranda
,
Raquel V. C. Oliveira
,
Marcel de Souza Borges Quintana
,
Paula Gonçalves Viana
,
Anna Barreto Fernandes Figueiredo
,
Cindy Caroline dos Santos Honorato
,
Gabriela Reis Pereira-Oliveira
,
Jessica Nunes Silva
,
Tânia Pacheco Schubach
,
Isabella Dib Ferreira Gremião
* ORCID logo
Version 1 : Received: 26 December 2023 / Approved: 26 December 2023 / Online: 27 December 2023 (09:45:46 CET)

A peer-reviewed article of this Preprint also exists.

Reis, E.G.; Pereira, S.A.; Miranda, L.H.M.; Oliveira, R.V.C.; Quintana, M.S.B.; Viana, P.G.; Figueiredo, A.B.F.; Honorato, C.C.S.; Pereira-Oliveira, G.R.; Silva, J.N.; Schubach, T.M.P.; Gremião, I.D.F. A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis. J. Fungi 2024, 10, 101. Reis, E.G.; Pereira, S.A.; Miranda, L.H.M.; Oliveira, R.V.C.; Quintana, M.S.B.; Viana, P.G.; Figueiredo, A.B.F.; Honorato, C.C.S.; Pereira-Oliveira, G.R.; Silva, J.N.; Schubach, T.M.P.; Gremião, I.D.F. A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis. J. Fungi 2024, 10, 101.

Abstract

Feline sporotrichosis is an endemic disease with high occurrence in Brazil. Itraconazole (ITZ), remains the drug of choice for treating this disease in cats, despite the increasing reports of therapeutic failure. A controlled, randomized clinical trial was performed on 166 naive cats with sporotrichosis to assess the effectiveness and safety of the combination therapy (ITZ+KI) com-pared with ITZ monotherapy. Cats were randomly allocated in two treatment groups: G1 - ITZ 100 mg/cat/day and G2 - ITZ 100mg/cat/day + KI 2.5-20 mg/kg/day. Cats treated in G2 presented 77% more risk of reaching clinical cure (a positive effect) than those treated in G1, even when controlled by negative predictors. The survival curves of the two treatment protocols indicates that clinical cure was achieved faster in G2. An increase in the KI dose was necessary in 28 cats due to persistence of clinical signs. Adverse reactions were equally frequent in both groups and manageable with a temporary drug suspension and/or a hepatoprotective therapy. The combination therapy was associated with a higher cure rate and a shorter treatment time, suggesting that ITZ+KI arises as a better option for treating feline sporotrichosis and should be considered as the first-line treatment in the presence of negative predictors.

Keywords

sporotrichosis; Sporothrix; cats; itraconazole; potassium iodide; treatment; combination therapy

Subject

Medicine and Pharmacology, Veterinary Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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