Trilostane 60mg capsules

Cushing's syndrome is one of the most common endocrine disorders in dogs and is typically managed with long-term medical treatment. Several pharmacological agents are available: trilostane, mitotane, ketoconazole, cabergoline, selegiline, and aminoglutethimide, but their comparative effects on survival remain unclear. This systematic review and meta-analysis compared the impact of these agents on survival outcomes in dogs with naturally occurring diseases. A comprehensive search of MEDLINE, Embase, Web of Science, Academic Search Complete, and the Cochrane Library was conducted between 1 September 2024 to 3 January 2025. Eligible studies included dogs diagnosed with Cushing's syndrome that reported survival outcomes for at least one of the specified treatments. Five studies (n = 295 dogs) met the inclusion criteria, with trilostane and mitotane providing sufficient data for meta-analysis. Pooled mean difference in survival time across four studies was 85.1 days (95% CI: -255.9 to 85.7, p = 0.21) with substantial heterogeneity (I2 = 89%), indicating no statistically significant difference between the drugs. In contrast, pooled survival rates at fixed intervals favored trilostane, with an 11% higher survival at 36 months (p = 0.005) and no heterogeneity observed (I2 = 0%). These findings suggest trilostane may offer long-term survival benefits over mitotane.

Abstract licence: CC BY

Simple Summary Drugs rarely are aimed at a single target. More frequently, drugs can affect the functioning of multiple systems as a consequence of the different levels of activity of the aimed target or because of the effects caused by drug interactions with the other possible targets. Trilostane is a veterinary drug used for very specific diseases, but the array of possible beneficial effects generated by trilostane could be useful for diseases different from those indicated for the use of this drug. Additionally, although abandoned as a drug to treat diseases in human patients, the use of trilostane in animals to address conditions still needing effective therapies could give trilostane appeal for a new appraisal in disorders common to humans and animals, such as epilepsy, anxiety, and depression. This review of the present evidence suggests that trilostane is a powerful tool to stimulate the production of hormones (steroids), making the brain more resilient to injuries and traumatic events, preventing more negative consequences caused by the triggered neuroinflammatory responses (a consequence common to seizures and, but not only, depression), which definitely could lead to more severe conditions.

Abstract licence: CC BY