Efficacy and safety of imidacloprid 10 %/moxidectin 1 % spot-on formulation in the treatment of feline infection by Capillaria aerophila
Open accessAbstract
The nematode Capillaria aerophila (Trichuroidea, Trichuridae) affects the respiratory system of cats and other animals and occasionally of human beings. Infected cats may show bronchovesicular sounds, inflammation, sneezing, wheezing and, chronic cough and, sometimes, bronchopneumonia and respiratory failure. The present study evaluated the efficacy and safety of the antiparasitic spot-on formulation containing imidacloprid 10%/moxidectin 1 % (Advocate®, Bayer Animal Health) in the treatment of natural feline infection with the lungworm C. aerophila. The efficacy of Advocate® administered once was tested on days 7 ± 1 and 11 ± 1 following treatment at day 0 and compared to faecal egg counts on days -6 ± 1 and -2 ± 1. Overall, 36 cats treated either with Advocate® (treatment group, n = 17 cats) or left untreated (control group, n = 19 cats) were included in the study. Geometric means of faecal egg counts values in eggs per gram of faeces were 124.03 prior to treatment and 0.26 posttreatment in treatment group, while 107.03 and 123.94 pre- and posttreatment in the untreated cats. Post-baseline egg counts showed a 99.79 % reduction in Advocate®-treated animals in comparison with cats which were left untreated. Also, treated cats showed no adverse events. This trial demonstrated that Advocate® spot-on formulation is safe and effective in the treatment of feline lung capillariosis caused by C. aerophila.
AI snapshot
Written from the paper’s full text.
TL;DR
A controlled field trial tested a single spot-on dose of imidacloprid 10 %/moxidectin 1 % (Advocate®) in cats naturally infected with the lungworm *Capillaria aerophila*. Treatment reduced faecal egg counts by 99.79 % versus untreated controls and produced no adverse events in treated cats.
Key findings
- In 36 enrolled cats (17 treated, 19 untreated controls), geometric mean faecal egg counts (EPG) were 124.03 at baseline and 0.26 posttreatment in the Advocate® group, versus 107.03 and 123.94 in controls.
- Relative change from baseline was 99.79 % in treated cats and −15.8 % in untreated cats; the between-group difference was statistically significant (text: P < 0.0001; Table 1: P = 0.0002).
- No adverse events were recorded in any treated cat. Three cats had clinical signs before treatment: two treated cats had cough due to capillariosis plus concomitant *Aelurostrongylus abstrusus*, and one untreated control cat had cough due to *C. aerophila* plus diarrhoea of unknown origin.
- At study completion, all cats but one were clinically healthy; respiratory distress resolved in the two symptomatic treated cats, while cough persisted in the untreated control cat and resolved after rescue treatment.
Methods
- Controlled, randomised, multicentric field trial conducted July 2009–October 2011 under Good Clinical Practice; 542 cats were screened at seven veterinary practices in central Italy, and 36 infected cats from six sites were recruited and allocated 1:1 to treatment or untreated control.
- Cats received a single label-dose application of Advocate® spot-on at day 0; controls received no compound until rescue treatment after study completion. Inclusion required cats >9 weeks old, >1 kg, and positive for *C. aerophila* eggs at least once among four pretreatment examinations.
- Quantitative McMaster faecal examinations were performed at days −6 ± 1, −2 ± 1, 7 ± 1, and 11 ± 1. Efficacy used the highest pretreatment count as baseline and the highest posttreatment count, analysed on the log-transformed scale with ANCOVA adjusted for baseline; efficacy was considered effective if ≥90 %.
Limitations
- The paper states that a diagnostic sensitivity <100 % for the McMaster method cannot be ruled out compared with necropsy or experimental molecular assays, although it was chosen as the most reliable approach for detecting *C. aerophila* eggs.
- The paper notes that prior information on field efficacy of parasiticides against feline *C. aerophila* infection was fragmentary and mostly limited to single clinical cases.
- Evident from the text: the study enrolled a small number of cats (36 total; 17 treated), relied on copromicroscopic rather than necropsy confirmation, and assessed posttreatment egg counts only at days 7 ± 1 and 11 ± 1, so longer-term efficacy and reinfection dynamics were not evaluated.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
0 of 10 cited sources checked · 0 supported · 0 flagged
- Findingown data
Relative change from baseline was 99.79% in treated cats and −15.8% in control cats.
“Relative change from baseline was 99.79 and −15.8 % in the treated and control cats, respectively (Table 1).”
Quote in the paperSubstantial claim - Findingown data
Baseline geometric mean EPG was 124.03 in the Advocate group and 107.03 in the untreated control group.
“Geometric means of EPG at baseline were 124.03 (arithmetic mean 152.9 ± 128.1) in the Advocate® and 107.03 (arithmetic mean 118.4 ± 53.3) in the untreated control group.”
Quote in the paperNot a substantial claim - Findingown data
In the treatment group, arithmetic mean EPG reduced from 152.9 (±128.1) at baseline to 2.9 (±12.1) at day 7 or 11.
“In the treatment group, EPG value was reduced from 152.9 (±128.1) at baseline to 2.9 (±12.1) at day 7 or 11.”
Quote in the paperSubstantial claim - Findingown data
At completion of the study, all 36 enrolled cats but one were clinically healthy.
“At completion of the study, all 36 enrolled cats but one were clinically healthy.”
Quote in the paperNot a substantial claim - Findingown data
Posttreatment geometric mean EPG was 0.26 in the treatment group and 123.94 in the control group.
“Geometric means of EPG were 124.03 (baseline) and 0.26 (posttreatment) in the treatment group and 107.03 (baseline) and 123.94 (posttreatment) in the control cats.”
Quote in the paperSubstantial claim
- Findingown data
In untreated animals, arithmetic mean EPG increased from 118.4 (±53.3) to 163.2 (±165.7).
“In the untreated animals, an increase from 118.4 (±53.3) to 163.2 (±165.7) EPG was found.”
Quote in the paperSubstantial claim - Findingown data
No adverse events were recorded in any Advocate-treated cats.
“No AEs were recorded in any of the treated cats.”
- Also stated in: § Abstract · plain
“Also, treated cats showed no adverse events.”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
There was no statistically significant difference in pretreatment egg counts between the Advocate and control groups (P = 0.568).
“No statistically significant (P = 0.568) differences in egg counts in pretreatment period between the two groups were found.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
The modified quantitative McMaster method is the most reliable approach to detect C. aerophila eggs.
“Even though a sensitivity <100 % cannot be ruled out, if compared with necropsy or experimental molecular assays, the use of this method still is the most reliable approach to detect C. aerophila eggs and, for this reason, it was chosen for the success criteria in the study.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Sloss et al. 1994
Not checked in the free run.
- Study design and conductnone given
The diagnostic sensitivity of the test was assured by two consecutive quantitative examinations repeated twice at each pre- and posttreatment sample collection.
“The diagnostic sensitivity of the test, and thus the reliability of the data obtained, was assured by two consecutive quantitative examinations repeated twice at each of the pre- and posttreatment sample collection.”
Quote in the paperSubstantial claim - Interpretationown data
The present study fills an important gap in treatment options for lung capillariosis in cats.
“The present study fills an important gap in treatment options for lung capillariosis in cats, in that the macrocyclic lactone moxidectin present in the Advocate® spot-on formulation proved to be effective against C. aerophila in a number of infected cats.”
Quote in the paperNot a substantial claim- Rests on an assumption: At the time the study started, no drug was licensed with C. aerophila as an indication for use in cats.
- Study design and conductreasoning
Identification of C. aerophila ova in positive samples was performed with no risks of misidentification.
“Furthermore, the identification of C. aerophila ova in positive samples was carefully performed with no risks of misidentification.”
Quote in the paperNot a substantial claim
- May combine two claims. 11
- Classified as probably not a substantial claim. 8
May combine two claims.
Findingown dataClinical symptoms were present prior to treatment in three cats and were not considered related to the study medication.
“Clinical symptoms were present prior to treatment (day 0) in three cats, thus were not considered to be related to the study medication.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe difference between Advocate-treated and untreated cats in change from baseline EPG was 4.672 (95% CI 4.128-5.216), statistically significant at P < 0.0001, showing superiority of Advocate.
“The difference between groups in change from baseline was 4.672 (95 % confidence interval from 4.128 to 5.216) which is statistically significant at P < 0.0001, thus showing superiority of Advocate® spot-on compared to the untreated group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataRespiratory distress disappeared in the two symptomatic treated cats, while cough persisted in one untreated control cat.
“Specifically, respiratory distress disappeared in the two symptomatic cats from site E while cough was still present in the untreated cat of the control group.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAdvocate can be used safely even in cats heavily infected with adult Dirofilaria immitis.
“and can be used safely even in cats heavily infected with adult Dirofilaria immitis (Arther et al. 2005).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Arther et al. 2005 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone givenThe efficacy analysis was performed on the log-transformed scale using an analysis of covariance adjusted for baseline egg counts.
“The analysis of the efficacy criterion was performed on the log-transformed scale using an analysis of covariance adjusted for baseline egg counts.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAdvocate is highly effective in the treatment of feline otocariosis.
“As key examples, this formulation has shown to be highly effective in the treatment of feline otocariosis (Fourie et al. 2003)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Fourie et al. 2003 source
Not checked in the free run.
May combine two claims.
Study design and conductown dataAll enrolled 36 cats completed the study according to protocol and were included in efficacy calculations.
“All enrolled 36 cats completed the study according to the protocol. They were appropriately treated, no cats were removed from the study subsequent to inclusion for any reason and all of them were included in efficacy calculations.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductcitationThe study was a controlled, randomised, multicentric field trial conducted in accordance with Good Clinical Practice.
“The study was carried out from July 2009 to October 2011 as a controlled, randomised, multicentric field trial in accordance to Good Clinical Practice by the European Agency for the Evaluation of Medicinal Products (CVMP/VICH GL7, July 2000; CVMP/VICH GL19, July 2001).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites CVMP/VICH GL7, July 2000
Not checked in the free run.
- cites CVMP/VICH GL19, July 2001
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataCats were allocated to treatment and control groups as per a randomised block design in a 1:1 ratio.
“At day 0, the animals were clinically examined prior to treatment and then allocated to two groups, one treated (treatment group) with the spot-on solution containing imidacloprid 10 %/moxidectin 1 % (Advocate®) and one left untreated (control group), as per a randomised block design in a ratio of 1:1.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAdvocate is highly effective and safe for the treatment of feline respiratory infection caused by Aelurostrongylus abstrusus.
“Also, a recent experimental study has demonstrated the high efficacy and safety of Advocate® for the treatment of feline respiratory infection caused by the metastrongylid lungworm Aelurostrongylus abstrusus (Traversa et al. 2009a).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Traversa et al. 2009a
Not checked in the free run.
May combine two claims.
PremisecitationInformation on effective and safe anthelmintic therapy of pulmonary capillariosis is almost non-existent and the scanty information published relates to few single clinical cases.
“Nevertheless, information on effective and safe anthelmintic therapy of pulmonary capillariosis is almost non-existent and those scanty information published are related to few single clinical cases.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Endres 1976
Not checked in the free run.
- cites Norsworthy 1975
Not checked in the free run.
- cites Barrs et al. 2000 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe investigator laboratory was blinded.
“The blinded investigator laboratory (site A) was the Parasitology Laboratory at the Department of Comparative Biomedical Sciences, University of Teramo, Italy.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone givenThe percentage decrease was considered effective if efficacy was at least 90%.
“The percentage decrease was considered effective if efficacy was at least 90 %.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataA single administration of Advocate spot-on at a minimum dose of 10 mg imidacloprid and 1 mg moxidectin per kg body weight is safe and effective in the treatment of feline infection by C. aerophila under field conditions.
“This study demonstrated that a single administration of Advocate® spot-on at a minimum dose per kilogram body weight of 10 mg imidacloprid and 1 mg moxidectin is safe and effective in the treatment of feline infection by C. aerophila under field conditions.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningAfter the recent experimental demonstration that Advocate is effective against A. abstrusus, the present study allows to include C. aerophila among feline parasitic nematodes that can be effectively and safely treated by this spot-on.
“After the recent experimental demonstration that Advocate® is effective against the major cat lungworm A. abstrusus (Traversa et al. 2009a), the present study allows to include another respiratory nematode affecting cats, C. aerophila, among the feline parasitic nematodes that can be effectively and safely treated by this spot-on.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Traversa et al. 2009a
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningAdvocate has advantages in current practice for treatment of cat capillariosis: the possibility of a single dose and easy-to-apply spot-on administration.
“Indeed, Advocate® has advantages in the current practice for the treatment of cat capillariosis, i.e. the possibility of a single dose and the easy-to-apply spot-on administration.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataAdvocate spot-on formulation is safe and effective in the treatment of feline lung capillariosis caused by C. aerophila.
“This trial demonstrated that Advocate® spot-on formulation is safe and effective in the treatment of feline lung capillariosis caused by C. aerophila.”
Quote in the paperSubstantial claim
The paper relies on this without support.
At the time the study started, no drug was licensed with C. aerophila as an indication for use in cats.
“At the time the study starts, there was no drug licensed with C. aerophila as an indication for use in cats.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Italy is a key country for the emergence and spreading of cardio-pulmonary nematodes, with D. immitis hyper-endemic in the North and expanding southward, A. vasorum potentially spreading in all the territory, and C. aerophila and A. abstrusus widely distributed with prevalence rates up to 7% and 20% respectively.
“At the same time Italy is a key country for the emergence and spreading of cardio-pulmonary nematodes, with D. immitis being hyper-endemic in the North and expanding southward, A. vasorum potentially spreading in all the territory, and C. aerophila and A. abstrusus widely distributed with prevalence rates up to 7% and 20% respectively [3,56,152,169,170].”
From Fleas infesting pets in the era of emerging extra-intestinal nematodes (2013) · cites this paper as [169]
The spot-on formulation containing moxidectin is effective in the treatment of feline aelurostrongylosis and capillariosis.
“The recent reports of the efficacy of the spot-on formulation containing moxidectin in the treatment of feline aelurostrongylosis and capillariosis [169,191] should encourage further studies aiming to also investigate the applicability of chemopreventative approaches against these parasites, as recently assessed for dog angiostrongylosis [136].”
From Fleas infesting pets in the era of emerging extra-intestinal nematodes (2013) · cites this paper as [169]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Screening-site range omits site H
MinorThe screening counts list seven sites but label them B-G, a range of only six sites. Elsewhere, the paper identifies site H and reports enrolled cats from it, so the range should include H.
“Five hundred and forty-two cats, i.e. 107, 125, 75, 32, 101, 27 and 75 in sites B–G, respectively, were subjected to a screening examination”
“and 8 from site H (10.6 %).”
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Bowman, D. D. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-54396-5.00013-1 · Cited by 13 · see citing works
de Weyer, Y. V., Santos, M. C., Williams, N., Gonçalves, A. M., Hawley, W., McVay, K., & Bexton, S. (2023) · Journal of Helminthology · doi:10.1017/s0022149x23000718 · Cited by 11 · see citing works
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Rohdich, N., Zschiesche, E., Wolf, O., Loehlein, W., Kirkova, Z., Iliev, P. T., Rapti, D., Postoli, R., Capári, B., Farkas, R., et al. (2018) · Parasites & Vectors · doi:10.1186/s13071-018-3169-x · Cited by 8 · see citing works
Dog and cat respiratory capilariasis - clinical, parasitological and epidemiological significance
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Self-citationSzatmári, V. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-22652-3.00036-0 · Cited by 3 · see citing works
Feline pulmonary nematodes; new challenges for veterinary practitioners
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Nematode Infections of the Respiratory Tract
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Self-citation
- Authors
- Traversa, D., Di Cesare, A., Di Giulio, E., Castagna, G., Schaper, R., Braun, G., Lohr, B., Pampurini, F., Milillo, P., & Strube, K.
- Affiliations
- University of Teramo (IT)
- Bayer (Germany) (DE)
- Bayer (Italy) (IT)
- Corresponding author
- Traversa, Donato
- Venue
- Parasitology Research
- Published
- 2012-07-11
- Volume
- 111
- Issue
- 4
- Pages
- 1793-1798
- ISSN
- 0044-3255 (ISSN-L)
- 0932-0113
- 1432-1955
- PMC
- PMC3447147
- OpenAlex
- W2051937425
- Cited by
- 33
- References
- 24
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 7 · 2014: 2 · 2013: 3
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Parasitology Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UniTERAMO Research Catalog (University of Teramo) (submittedVersion)
- Funders
- Regione Abruzzo
- Regione Marche
- Bayer Animal Health
- Topics
- Health Sciences › Veterinary › Small Animals › Helminth infection and control
- Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Keywords
- Capillaria aerophila, imidacloprid, moxidectin, spot-on formulation, lawyers, antiparasitic drug efficacy, fecal egg count, treatment safety, cats
- MeSH terms
- Neonicotinoids, Animals, Anthelmintics, Capillaria, Cat Diseases, Cats, Drug Combinations, Feces, Imidazoles, Nitro Compounds, Parasite Egg Count, Enoplida Infections, Macrolides
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