A randomized, blinded, controlled, multi-centered field study assessing the treatment of gastrointestinal nematode infections in cats with fluralaner plus moxidectin spot-on solution (Bravecto\xae Plus)

Nadja Rohdich,Dhimitër Rapti,Zvezdelina Kirkova,Balázs Capári,Róbert Farkas,Wolfgang Loehlein,Oliver Wolf,Petar Iliev,Rezart Postoli,Eva Zschiesche,Rainer K A Roepke

doi:10.1186/s13071-018-3169-x

Abstract

BackgroundA spot-on formulation containing fluralaner (280 mg/ml) plus moxidectin (14 mg/ml) (Bravecto® Plus) was developed for the treatment of nematode infections as well as providing 12 weeks of protection against insect and acarine parasites in cats. The effectiveness and safety of this product against feline gastrointestinal nematodes was assessed in naturally-infested, client-owned cats under field conditions in Albania, Bulgaria, Germany and Hungary.MethodsTo be eligible for enrollment in this investigator-blinded study cats had to be at least 10 weeks-old, weigh at least 1.2 kg, be clinically healthy, and have a faecal sample testing positive for nematodes no more than eight days prior to treatment. Cats were stratified into blocks of three in order of presentation at each center and randomly allocated in a 2:1 ratio to be treated topically on Day 0 with fluralaner plus moxidectin (minimum dose rates 40 mg/kg and 2 mg/kg, respectively) or emodepside plus praziquantel (minimum dose rates 3 mg/kg and 12 mg/kg, respectively) (Profender®). Faecal samples were collected from cats prior to treatment and 14 ± 4 days later.ResultsThere were 182 cats randomized to the fluralaner plus moxidectin group, and 91 to the emodepside plus praziquantel group. Prior to treatment the most commonly identified nematode egg was Toxocara cati, found in 79.1 and 82.4% of cats in the fluralaner plus moxidectin and emodepside plus praziquantel groups, respectively. Eggs of Toxascaris leonina were found in 8.2 and 6.6% of cats; of hookworms in 30.8 and 24.2%; and of Capillaria spp. in 7.1 and 4.3%, respectively. After treatment, faecal samples from 98.3% of fluralaner plus moxidectin treated and 96.6% of emodepside plus praziquantel-treated cats were free of nematode ova. Geometric mean faecal egg count reductions for T. cati, the only eggs found in post-treatment faecal samples, were 99.97% and 99.93%, respectively. Treatment with fluralaner plus moxidectin was non-inferior to emodepside plus praziquantel. Both products were safe and well tolerated by cats treated under field conditions.ConclusionsThis field study confirms that, in addition to 12-week extended duration flea and tick control, fluralaner plus moxidectin provides broad spectrum treatment of nematodes in cats.

Highlights

A spot-on formulation containing fluralaner (280 mg/ml) plus moxidectin (14 mg/ml) (Bravecto® Plus) was developed for the treatment of nematode infections as well as providing 12 weeks of protection against insect and acarine parasites in cats
More than 90% of enrolled cats in each group were described as either domestic or European, and 61.5% were two years of age or less (11.7% were older than five years), with cats from 11 or 12 weeks of age up to 15 years enrolled in both groups
Ten cats from the ITT population were excluded from the per protocol (PP) population: five cats because the pre-treatment sample was negative, two because of a protocol deviation, one was lost to follow up, and one died in a road traffic accident

Summary

Introduction

A spot-on formulation containing fluralaner (280 mg/ml) plus moxidectin (14 mg/ml) (Bravecto® Plus) was developed for the treatment of nematode infections as well as providing 12 weeks of protection against insect and acarine parasites in cats. Gastrointestinal nematode infections are common in cats in Europe, with an estimated prevalence of up to 40% [1,2,3,4,5,6,7]. In addition to posing a threat to the health of infected cats, the most commonly occurring nematode, Toxocara cati, has zoonotic potential. The European Scientific Counsel Companion Animal Parasites (ESCCAP) recommends that adult cats with access to the outdoors be treated for nematodes at least four times per year [8]. Where there is a higher risk of nematode infection (kittens, adult cats with a predominantly outdoor lifestyle), additional treatment may be given [8, 9]

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