Moxidectin

Shortened egg reappearance after ivermectin or moxidectin use in horses in the UK.[Pubmed:27938707]

Vet J. 2016 Dec;218:36-39.

This study reports ivermectin and Moxidectin egg reappearance periods (ERP) from UK horses with persistently positive faecal egg counts (FEC), defined as positive FEC within the ERP of an anthelmintic post-treatment, or with FECs that remained positive after the normal ERP post-anthelmintic treatment. A selected population of UK pleasure horses deemed at high risk of strongyle infection was studied. The earliest ERP recorded after ivermectin or Moxidectin, using first positive FEC, was 5 weeks. From 16 premises where Moxidectin was used, five had ERP >/=12 weeks using two further metrics. For premises where Moxidectin was administered to only one animal (present or tested), and evaluated as one group (n = 61), ERP was >/=10 weeks. For premises where ivermectin was used, the ERP was >/=5 weeks. Premises with only one horse (present or tested), dosed with ivermectin (n = 31), analysed as one group, demonstrated egg reappearance >/=6 weeks. These field data suggest shortened ERPs following macrocyclic lactone treatment compared to previously published values (8-10 and >13 weeks respectively) when these drugs were first marketed.

Strongyle egg reappearance period after moxidectin treatment and its relationship with management factors in UK equine populations.[Pubmed:28249767]

Vet Parasitol. 2017 Apr 15;237:70-76.

Parasitic nematodes, particularly cyathostomins, are ubiquitous in grazing horses world-wide. Considerable burdens of cyathostomin larvae can encyst in the large intestinal wall. The most recommended treatment against these pathogenic stages is Moxidectin. Information is required on how effective Moxidectin is against cyathostomin populations in different regions. The objectives here were to determine the efficacy of Moxidectin treatment and estimate the strongyle egg reappearance period (ERP) after treatment in several equine populations, to confirm the type of strongyle nematodes present and to identify other (i.e. management) factors associated with shortened ERP. Eight yards were recruited and Moxidectin in combination with praziquantel administered to all horses (n=261). Faecal egg count (FEC) analysis was performed at weeks 0, 2, 6, 10 and 12 after treatment to determine efficacy and ERP. The ERP was estimated using two previously published methods. Morphological identification of cultured third stage larvae from the sample population was compared to a Strongylus vulgaris-specific end-point PCR to examine the presence of S. vulgaris in samples before and after treatment. Strongyle egg shedding patterns were also compared to worm management practices at each site. At 2 weeks post-treatment, Moxidectin was highly effective (faecal egg count reduction range, 99.9-100%). The strongyle ERP ranged from 6 weeks to >12 weeks depending on the calculation method applied. Only cyathostomin larvae were detected by morphological identification. The results from the coprocultures and PCR showed that S. vulgaris was absent before and after treatment. Analysis revealed that regular faecal removal from pasture was associated with lower average FEC and lower prevalence of egg shedding.

Efficacy of Moxidectin Versus Ivermectin Against Strongyloides stercoralis Infections: A Randomized, Controlled Noninferiority Trial.[Pubmed:28369530]

Clin Infect Dis. 2017 Jul 15;65(2):276-281.

Background: Infections with Strongyloides stercoralis are of considerable public health relevance. Moxidectin, a well-established drug in veterinary medicine under consideration for regulatory submission for the treatment of onchocerciasis, might serve as an alternative to the widely used ivermectin. Methods: We conducted an exploratory, randomized, single-blind trial to evaluate the efficacy and safety of Moxidectin (8 mg) vs ivermectin (200 mug/kg) against S. stercoralis infections. Cure rate (CR) against S. stercoralis was the primary outcome. Safety and efficacy against coinfections with soil-transmitted helminths and Opisthorchis viverrini were secondary outcomes. Noninferiority required the lower limit of the 95% confidence interval (CI) of the differences in CRs not exceed 7 percentage points. Results: A total of 127 participants were enrolled and randomly assigned to the 2 treatments whereby 1 participant per arm was lost to follow-up. We observed a CR of 93.7% (59/63) for Moxidectin compared to 95.2% (59/62) for ivermectin. Differences between CRs were estimated as -1.5% percentage points (95% CI, -9.6 to 6.5), thus the lower limit of the CI exceeds the noninferiority margin of 7 percentage points. No side effects were observed. CRs against hookworm infection were 57% (Moxidectin) and 56% (ivermectin). Low efficacy for both drugs against O. viverrini was observed. Conclusions: Moxidectin might be a safe and efficacious alternative to ivermectin for the treatment of S. stercoralis infection, given that only slight differences in CRs were observed. However, noninferiority could not be demonstrated. Larger clinical trials should be conducted once the drug is marketed. Clinical Trials Registration: Current Controlled Trials: ISRCTN11983645.

A multi-country study to assess the effect of a treatment with moxidectin pour-on during the dry period on milk production in dairy cows.[Pubmed:28259556]

Vet Parasitol. 2017 Apr 15;237:104-109.

A randomized clinical study was conducted in a total of 45 commercial dairy farms in France (14 farms), Germany (28 farms) and the UK (3 farms) to evaluate the effect of an anthelmintic treatment on milk yield in the subsequent lactation. A total of 1287 animals with suspected exposure to Ostertagia ostertagi were included in the study. Animals were treated during the dry period (7-77days before parturition) with Moxidectin pour-on (Cydectin((R)) 0.5% Pour-On, Zoetis; 638 animals) or left untreated (649 animals) according to a randomized block design. Animals were either heifers (n=296) or multiparous cows (n=991). The milk production was monitored at regular intervals after treatment up to 335days after lactation, and analysed using a general linear mixed model with the milk production as outcome variable and several random effects. The effect on milk yield after anthelmintic treatment over the whole subsequent lactation varied from no effect (-0.43kg/day; P=0.35) to an increase of milk yield with 2.35kg/day (P=0.01), depending on the study region and parity of the cows. Lactation curve analysis suggested that the treatment effect was mainly caused by a slower decay of the milk production in the treated animals compared to untreated animals. The present study highlights the beneficial effect of a topical treatment with Moxidectin before parturition on milk yield in the subsequent lactation, as well as the importance of a careful evaluation of nematode exposure risk based on local grazing management practices to guide and target production-based anthelmintic treatment decisions.

Moxidectin(ProHeart 6; CL301423; Cydectin) is an anthelmintic drug which kills parasitic worms (helminths), and is used for the prevention and control of heartworm and intestinal worms.

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