Nove metode liječenja boli kod životinja

master's thesis

• Title (english): New methods of treating pain in animals
• Author: Andrej Stupica
• Mentor: Frane Božić (mentor)
• Committee member: Andreja Prevendar Crnić (predsjednik povjerenstva)
• Committee member: Ozren Smolec (član povjerenstva)
• Committee member: Frane Božić (član povjerenstva)
• Committee member: Mirna Robić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Veterinary Medicine; Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Veterinary Medicine; Veterinary Public Health and Food Safety

Abstract

Širok izbor lijekova dostupan je za liječenje kronične boli, a kombinacija tih lijekova
općenito je najučinkovitiji način postizanja analgezije u pacijenata s dugotrajnom boli. Među
ostalim, nesteroidni protu-upalni lijekovi (NSPUL) su najčešće korištena skupina lijekova za
liječenje kronične boli kod ljudi i životinja. Činjenica da NSPUL djeluju protu-upalno je važna
jer mnoga bolna stanja uključuju bol zbog upale. Stoga su ovi lijekovi jedni od rijetkih
dostupnih u veterinarskoj medicini koji, ne samo da pacijentu ublažavaju bol, već također liječe
bol na njenom izvoru, odnosno upalu. U svijetu je nekoliko NSPUL-a odobreno za upotrebu
kod pasa, ali ih je malo odobreno za dugoročnu upotrebu kod mačaka i to samo u određenim
zemljama. Unatoč širokoj upotrebi i očitoj dobrobiti u mnogim slučajevima, NSPUL nisu
uvijek dovoljno učinkoviti kada se koriste kao monoterapija. Uz to, postoje problemi vezani uz
sigurnost i podnošljivost njihove uporabe kod pasa i mačaka. Stoga kronična bol ostaje klinički
izazovan entitet za liječenje, i doista, kronična bol poput boli povezane s OA jedan je od
najčešćih razloga za eutanaziju pasa. Dakle, postoji hitna potreba za razvojem učinkovitih
lijekova protiv boli povezane s OA kod pasa i mačaka.
Pretklinička i klinička istraživanja u proteklih nekoliko desetljeća jasno su pokazala važnu
ulogu čimbenika rasta živaca (NGF) u senzibilizaciji nociceptora u širokom rasponu akutnih i
kroničnih bolnih stanja uključujući postoperativnu i OA bol. Obrazloženje za uporabu antiNGF terapije u nekoliko bolnih stanja je snažno. Trenutačni dokazi pokazuju da terapija antiNGF monoklonskim protutijelima (mAb) ima pozitivne analgetske učinke i dobro se podnosi
do tri mjeseca kod pasa i mačaka koji pate od boli povezane s OA. Dodatno, čini se da
učinkovitost jedne injekcije traje najmanje četiri do šest tjedana, a veličina učinka je jednaka
ili veća od one koja se očekuje kod NSPUL-a. Prema tome, terapija anti-NGF mAb alternativa
je farmakološkim opcijama upravljanja boli koje su trenutno dostupne.

Abstract (english)

A variety of medications are available to treat chronic pain, and a combination of these
medications is generally the most effective way to achieve pain relief in patients with longterm pain. Among others, non-steroidal anti-inflammatory drugs (NSAIDS) are the most
commonly used group of drugs for the treatment of chronic pain in humans and animals. The
fact that NSAIDs have an anti-inflammatory effect is important, as many pain conditions are
associated with inflammation-related pain. Therefore, these drugs are among the few drugs
available in veterinary medicine that not only relieve the patient's pain, but also treat the pain
at its source, i.e. the inflammation. Several NSAIDs are approved for use in dogs worldwide,
but only a few are approved for long-term use in cats and only in certain countries. Despite
their widespread use and obvious benefit in many cases, NSAIDs are not always sufficiently
effective as monotherapy. In addition, there are issues related to the safety and tolerability of
their use in dogs and cats. Therefore, the treatment of chronic pain remains a clinical challenge,
and indeed chronic pain, such as pain associated with OA, is one of the most common reasons
for euthanasia of dogs. There is therefore an urgent need for the development of effective drugs
for OA-related pain in dogs and cats.
Preclinical and clinical research over the past decades has clearly demonstrated the important
role of nerve growth factor (NGF) in sensitising nociceptors in a variety of acute and chronic
pain conditions, including postoperative and OA pain. The rationale for the use of anti-NGF
therapy in various pain conditions is compelling. Current evidence shows that anti-NGF-MAb
therapy has positive analgesic effects in dogs and cats suffering from OA-related pain and is
well tolerated for up to three months. In addition, the efficacy of a single injection appears to
last at least four to six weeks, and the magnitude of the effect is expected to be equal to or
greater than that of NSAIDs. Therefore, anti-NGF-MAb therapy is an alternative to currently
available pharmacologic pain treatment options.

• Keywords: Kronična bol; Osteoartritis; Životinje; Analgetici
• Keywords (english): Chronic pain; Osteoarthritis; Animals; Analgesics
• Language: croatian
• URN:NBN: urn:nbn:hr:178:852492
• Study programme: Title: Veterinary Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica veterinarske medicine (doktor/doktorica veterinarske medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-02 12:24:29